Caseous calcification of the mitral annulus associated with stroke: report of two cases

Abstract

Objective: Caseous calcification of the mitral annulus (CCAM) is a rare complication of mitral annulus calcification (MAC). Whether CCAM should be considered as a cardiac source of stroke or a simple marker of atherosclerosis remains a matter of debate.

Method: Herein, we report two patients with stroke and CCAM.

Results: The first one was associated with extensive aortic arch atheroma, while CCAM was the only potential cause in the second case. Transthoracic echocardiography was normal in both cases and CCAM was diagnosed on transesophageal echocardiography.

Conclusion: These observations suggest that CCAM should be added to the list of minor cardioembolic sources of stroke but also requires a perfect control of vascular risk factors.

Keywords: Atherosclerosis; Athérosclérose; Calcification caséeuse; Calcification de l’anneau mitral; Caseous calcification; Facteurs de risque cardiovasculaire; Infarctus cérébral; Mitral annulus calcification; Stroke; Vascular risk factors.