Related Experiment Videos
Cardioembolic stroke in primary oxalosis with cardiac involvement
G Di Pasquale1, M Ribani, A Andreoli
1Division of Cardiology, Bellaria Hospital, Bologna, Italy.
Insights
Primary oxalosis, a rare metabolic disorder, can cause heart calcification leading to stroke. This case highlights cardiac oxalosis as a potential, often overlooked, cause of cerebral embolism in young adults.
Area of Science:
- Nephrology
- Cardiology
- Metabolic Disorders
Background:
- Primary oxalosis is a rare inherited metabolic disorder.
- It leads to calcium oxalate deposition in kidneys and other organs.
- Cardiac involvement can be severe but is often undiagnosed.
Observation:
- A 34-year-old man presented with stroke symptoms (hemiparesis, aphasia).
- Investigations revealed primary oxalosis.
- Echocardiography showed massive intracardiac calcifications.
Findings:
- The patient's stroke was attributed to cerebral infarction caused by left middle cerebral artery occlusion.
- Cardiac oxalosis was identified as the source of intracardiac calcifications.
- No other causes for the stroke were found.
Implications:
- Cardiac oxalosis is a potential occult source of cerebral embolism.
- This diagnosis should be considered in patients with unexplained stroke.
- Early recognition of primary oxalosis is crucial for managing cardiovascular risks.
Abstract:
Primary oxalosis is a rare disorder of oxalate metabolism, characterized by nephrocalcinosis, nephrolithiasis, and extrarenal deposition of calcium oxalate in several tissues, including the heart. We report the case of a 34-year-old man with sudden right hemiparesis and aphasia from the occlusion of the left middle cerebral artery. Clinical features and the results of laboratory investigations led to the diagnosis of primary oxalosis. Two-dimensional echocardiography disclosed the presence of massive intracardiac calcifications compatible with deposition of calcium oxalate. The absence of other causes of stroke strengthened a cause-and-effect relation between cardiac oxalosis and cerebral infarction. Consequently, cardiac oxalosis should be considered among possible occult cardiac sources of cerebral embolism.