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[A case of caseous calcification of mitral annulus resulting in multiple cerebral infarctions]

Yoshifumi Ogasawara1, Kagari Mano1,2, Fumiaki Henmi1

  • 1Department of Neurology, Toranomon Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|February 1, 2023
PubMed

Insights

A rare case of stroke caused by a mobile mitral valve mass (caseous calcification of the mitral annulus) highlights the importance of cardiac evaluation for embolic events.

Area of Science:

  • Cardiology
  • Neurology
  • Cardiovascular Surgery

Background:

  • Mitral annular calcification (MAC) is common in the elderly.
  • Caseous calcification of the mitral annulus (CCMA) is a rare subtype of MAC.
  • CCMA can present as a mobile mass with embolic potential.

Observation:

  • A 73-year-old woman presented with acute cerebral infarctions.
  • Echocardiography revealed a large, mobile CCMA on the mitral valve annulus.
  • A new infarction occurred, indicating embolic events from the CCMA.

Findings:

  • The CCMA was resected, and mitral valve replacement was performed.
  • This case represents a rare instance of embolic cerebral infarction caused by CCMA.
  • CCMA can progress to a calcified amorphous tumor (CAT) with embolic risks.

Implications:

  • Early detection and surgical intervention for CCMA are crucial in preventing recurrent embolic events.
  • This case underscores the need for comprehensive cardiac assessment in patients with cryptogenic stroke.
  • Understanding CCMA as a source of embolism can improve stroke management strategies.

Keywords:
calcified amorphous tumorcaseous calcification of the mitral annulusmitral annular calcificationmultiple cerebral infarctions

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