Related Experiment Video
Updated: Jun 11, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Mitral valve calcific embolization leading to myocardial infarction in a patient with end-stage renal disease
Yousef Hailan1, Nazar Mohammad1, Hakam Alzaeem1
1Cardiology Department, Heart Hospital, Hamad Medical Corporation, Al Rayyan Road, Hamad Medical City, Doha, P.O. Box 3050, Qatar.
Insights
Calcific coronary embolism, a rare cause of acute coronary syndrome (ACS), occurred in an end-stage renal disease (ESRD) patient. Multimodal imaging and histopathology confirmed calcified debris, not thrombus, as the cause.
Area of Science:
- Cardiology
- Nephrology
- Pathology
Background:
- Acute coronary syndrome (ACS) is often caused by atherothrombosis.
- Non-atherosclerotic causes, such as coronary embolism, are critical in end-stage renal disease (ESRD) patients.
- Tertiary hyperparathyroidism is a common comorbidity in ESRD.
Abstract:
While atherothrombosis accounts for the majority of acute coronary syndrome (ACS) cases, non-atherosclerotic mechanisms like coronary embolism are important considerations in end-stage renal disease (ESRD). A 52-year-old woman with ESRD and tertiary hyperparathyroidism presented with myocardial infarction. Echocardiography identified mobile mitral valve masses. Angiography showed a left anterior descending artery occlusion, but intravascular ultrasound revealed minimal plaque burden. Histopathological analysis of aspirated material confirmed calcified necrotic debris rather than thrombus. Despite concurrent COVID-19 infection, the rigid mechanical behavior of the masses during attempted percutaneous aspiration distinguished the pathology from infective endocarditis. This case highlights calcific coronary embolism as a rare ACS cause in ESRD patients. Multimodal imaging and histopathology are crucial for accurate diagnosis.
More Related Videos
Related Concept Videos
Mitral Stenosis I: Introduction
Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral Regurgitation III: Medical Management
Mitral Stenosis III: Medical Management
Mitral Regurgitation I: Introduction
Mitral Regurgitation IV: Nursing Management

