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(Stroke. 1995;26:1697-1699.)
© 1995 American Heart Association, Inc.

Articles

Thrombus Associated With Mitral Valve Calcification

A Possible Mechanism for Embolic Stroke

James H. Stein, MD Jeffrey S. Soble, MD

From the Section of Cardiology, Department of Medicine, Rush Medical College, Chicago, Ill.

Correspondence to Dr Jeffrey S. Soble, Section of Cardiology, Rush–Presbyterian–St Luke's Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612.

Background Several studies have demonstrated an association between mitral annular calcification and stroke; however, the pathophysiological explanation remains speculative.

Case Descriptions We describe two patients with cerebral embolism in whom mitral valve calcification was demonstrated by transthoracic echocardiography. In both patients, transesophageal echocardiography identified a mass that appeared to be thrombus on the calcified portion of the mitral apparatus. There was no evidence of a hypercoagulable state or endocarditis in either case. Repeated transesophageal echocardiography after anticoagulation demonstrated resolution of the masses in both patients.

Conclusions These cases support the hypothesis that thrombus formation may be a pathophysiological link between ischemic cerebral events and mitral annular calcification in some patients.

Key Words: cardioembolic stroke • diagnostic imaging • mitral valve • thromboembolism

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