Key result
Multimodal imaging reveals mitral valve calcific embolism as a rare cause of MI in ESRD.
Why the study?
While atherothrombosis causes most acute coronary syndrome cases, non-atherosclerotic mechanisms such as coronary embolism are important considerations in end-stage renal disease.
Case Report (n=1)
This case highlights calcific coronary embolism as a rare cause of acute coronary syndrome in patients with end-stage renal disease, emphasizing the role of multimodal imaging and histopathology.
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.
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Hailan et al. (2026) conducted a case report in Myocardial infarction in end-stage renal disease (n=1). Calcific coronary embolism was evaluated. Calcific coronary embolism from mitral valve masses was identified as a rare cause of myocardial infarction in a patient with end-stage renal disease using multimodal imaging and histopathology.
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