Caseous mitral annular calcification in a patient with hypertrophic cardiomyopathy contributed to left ventricular outflow tract obstruction and acted as an embolic source for ischemic stroke.
Case Report (n=1)
Caseous mitral annular calcification can alter mitral valve geometry to promote left ventricular outflow tract obstruction and may act as an embolic source for stroke following liquefactive degeneration.
BACKGROUND: Caseous mitral annular calcification is a variant of annular calcification that may alter mitral valve geometry and represent a potential embolic source. CASE SUMMARY: A 50-year-old woman with exertional dyspnea was diagnosed with hypertrophic cardiomyopathy with left ventricular outflow tract obstruction. Transesophageal echocardiography revealed caseous calcifications of the posterior mitral annulus, causing leaflet displacement, promoting systolic anterior motion. Despite optimized medical therapy, she developed ischemic stroke, with imaging suggesting liquefactive degeneration of the masses as a potential embolic source. DISCUSSION: This case highlights a mechanistic link between mitral annular calcification and left ventricular outflow tract obstruction. Caseous mitral annular calcification may act as an embolic source following liquefactive degeneration. TAKE-HOME MESSAGES: Caseous mitral annular calcification may contribute to left ventricular outflow tract obstruction. Liquefactive degeneration of caseous mitral annular calcification may represent an embolic source. Persistent symptoms or embolic complications require recognition of structural mechanisms.
Bogini et al. (Mon,) conducted a case report in Hypertrophic cardiomyopathy (n=1). Caseous mitral annular calcification was evaluated. Caseous mitral annular calcification in a patient with hypertrophic cardiomyopathy contributed to left ventricular outflow tract obstruction and acted as an embolic source for ischemic stroke.