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Possible association of thrombotic, nonbacterial vegetations of the mitral ring-mitral annular calcium and stroke
J C Eicher1, F X Soto, L DeNadai
1Department of Cardiology, Dijon University Hospital, France.
The American Journal of Cardiology
|June 15, 1997
Insights
Mitral annular calcification can lead to stroke by forming blood clots. These thrombi attached to the mitral annulus resolved with anticoagulant therapy in three stroke patients.
Area of Science:
- Cardiology
- Neurology
Background:
- Mitral annular calcification (MAC) is linked to increased stroke risk.
- A direct causal link between MAC and stroke is rarely demonstrated.
Purpose of the Study:
- To report the direct association between mitral annular calcification and stroke.
- To describe thrombus formation on the mitral annulus in stroke patients.
Main Methods:
- Case series of three patients with stroke and mitral annular calcification.
- Echocardiographic and clinical data review.
- Assessment of treatment response to anticoagulation and antithrombotic therapy.
Main Results:
- Long, pedunculated thrombi were found attached to the calcified mitral annulus in all three patients.
- Stroke symptoms resolved in all patients following anticoagulant and antithrombotic treatment.
- Demonstrated a direct link between mitral annular calcification-associated thrombi and stroke.
Conclusions:
- Mitral annular calcification can be a direct source of emboli causing stroke.
- Anticoagulant and antithrombotic therapy are effective in managing stroke secondary to mitral annular calcification-associated thrombi.
Abstract:
Although numerous studies have shown an increased risk of stroke associated with mitral annular calcification, a direct link has rarely been demonstrated. We report the occurrence of long, pedunculated thrombi attached to the calcified mitral annulus in 3 patients who suffered from stroke, with resolution after anticoagulant and antithrombotic therapy.