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Spontaneous calcific coronary embolisation: necropsy x-ray study
Insights
Calcific emboli were found in 45% of hearts with severe left heart valve calcification. These emboli, particularly in the coronary arteries, are linked to mitral valve disease and ischemic heart symptoms.
Area of Science:
- Cardiology
- Radiology
- Pathology
Background:
- Advanced calcification of heart valves is a common condition.
- Spontaneous calcific emboli can arise from diseased heart valves.
- The clinical significance of these emboli is not fully understood.
Purpose of the Study:
- To investigate the presence and extent of spontaneous calcific emboli in hearts with advanced left heart valve calcification.
- To determine the association between calcific emboli and specific valvular heart diseases.
- To assess the relevance of coronary calcific emboli in patients with ischemic heart disease symptoms.
Main Methods:
- Examination of 31 hearts with advanced calcification of one or both left heart valves.
- Utilized X-ray (Mammograf) to detect and quantify calcific emboli.
- Analyzed the location and distribution of emboli within the coronary and systemic circulation.
Main Results:
- Calcific emboli were detected in 45% of the studied hearts.
- Intracoronary emboli were found in 14 cases (45%), with 205 intracoronary emboli identified.
- Calcific particles were present in the left ventricular cavity in 23% of cases, with 60 intravenous emboli identified.
- Embolization was most frequent and extensive in cases of postrheumatic mitral valve disease.
Conclusions:
- Spontaneous calcific emboli are a frequent finding in hearts with advanced left heart valve calcification.
- Coronary calcific emboli are associated with valvular heart disease, particularly mitral valve disease.
- Coronary calcific embolization should be considered in the differential diagnosis of ischemic heart disease in patients with valvular lesions.
Abstract:
Thirty-one hearts with advanced calcification of one or both left heart valves were investigated for the presence of spontaneous calcific emboli. X-ray (Mammograf) showed coronary emboli in 14 cases, that is, in 45% of the whole series. In seven cases (23%) calcific particles were also present in the left ventricular cavity. A total of 265 calcific emboli (205 intracoronary plus 60 intravenous) was demonstrated. The embolisation occurred most frequently and most extensively in association with postrheumatic mitral valve disease. Coronary calcific embolisation must be considered in the differential diagnosis of symptoms of ischaemic heart disease in patients suffering from valvular heart lesions.