Infective calcified amorphous tumor on mitral valve and critical course of left ventricular rupture

Handa, Kazuma; Fukui, Shinya; Shirakawa, Yukitoshi; Sakamoto, Tomohiko; Kitahara, Mutsunori; Kakizawa, Yumi; Nishi, Hiroyuki

doi:10.1016/j.jccase.2021.04.008

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Embolic events typically involve the brain or retina 10. Rare clinical presentations include multiple cardiac masses,11 presentation in the neonatal period,12 and infected CAT 13…”

Section: Discussionmentioning

confidence: 99%

Cardiac calcified amorphous tumour: an unusual aetiology for recurrent cardioembolic strokes

Sharma,

Annam,

Guler

et al. 2024

BMJ Case Rep

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We report an elderly woman with vascular risk factors and recurrent cardioembolic strokes in whom the stroke aetiology was finally ascertained to be a calcified amorphous tumour of the heart after repeated negative investigations for embolic aetiology over 2 years. This report discusses the clinical and imaging characteristics of calcified amorphous tumours of the heart with emphasis of recent advances in cardiac imaging.

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“…Embolic events typically involve the brain or retina 10. Rare clinical presentations include multiple cardiac masses,11 presentation in the neonatal period,12 and infected CAT 13…”

Section: Discussionmentioning

confidence: 99%

Cardiac calcified amorphous tumour: an unusual aetiology for recurrent cardioembolic strokes

Sharma,

Annam,

Guler

et al. 2024

BMJ Case Rep

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“…CAT may be associated with infection, but only 2 such cases have been reported [ 4 , 5 ]. Still there has been no case reported of antecedent infection until our report.…”

Section: Discussionmentioning

confidence: 99%

“…According to a systematic review of 42 published cases from 1997 to 2014, CAT is frequently associated with valvular disease (31%), end-stage renal disease (21%), mitral annular calcification (MAC) (14%), diabetes (14%), and coronary artery disease (12%) [ 2 ]. It may be associated with infection, but only 2 cases, to our knowledge, have been reported; and it remains uncertain whether infection was a cause or a complication of CAT [ 4 , 5 ]. A case of CAT with an antecedent infection, which would give a clue to this question, has not been reported so far.…”

Section: Introductionmentioning

confidence: 99%

Multiple cerebral infarctions due to calcified amorphous tumor growing rapidly from an antecedent infection and decreasing rapidly by detachment of fibrin and antithrombotic drugs: a case report

et al. 2022

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Background Calcified amorphous tumor (CAT) of the heart is a rare non-neoplastic intracardiac mass, a calcium deposition surrounded by amorphous fibrous tissue, and possibly causes cerebral embolism. Even rarer is CAT associated with infection, and no CAT with antecedent infection has been reported to our knowledge. In addition, although some CAT in patients on hemodialysis has been reported to grow rapidly, no case has been reported on CAT that grew and diminished rapidly in a short period of time. Here, we report the case of an 82-year-old Japanese woman with normal renal function who developed multiple cerebral infarctions due to CAT that grew rapidly, associated with inflammation from an antecedent infection, and diminished rapidly by detachment of fibrin on the mass surface and antithrombotic drugs. Case presentation The patient developed fever after dental treatment and found musical hallucination on the left ear worsened in degree and frequency. In a nearby clinic, she was treated with antibiotics, and her body temperature turned to normal in approximately 1 month. She presented to our hospital for workup on the worsened musical hallucination. Magnetic resonance imaging (MRI) showed multiple cerebral infarctions, and transthoracic echocardiography (TTE) revealed an immobile hyperechoic mass with an acoustic shadow arising from a posterior cusp of the mitral valve. CAT was suspected and treated with apixaban and aspirin. Follow-up MRI and TTE showed newly developed multiple cerebral infarctions and rapidly diminished CAT. Cardiac surgery was performed to resect the CAT. The pathological findings showed calcifications surrounded by amorphous fibrous tissue including fibrin, indicating CAT. The patient’s symptoms improved and no cerebral infarctions recurred in 4 months follow-up. Conclusion Inflammation from an antecedent infection can cause CAT to grow rapidly. Fibrous tissue including fibrin may attach to the surface of CAT, resulting in multiple cerebral infarctions. Fibrous tissue may detach and disappear by antithrombotic drugs, leading to a rapid diminishment of CAT in size.

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Clinical Features of Cardiac Calcified Amorphous Tumor: A Narrative Review

Takahashi,

Inaba,

Tsuchiya

et al. 2024

Cardiology in Review

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A cardiac calcified amorphous tumor (CAT) is a non-neoplastic cardiac mass composed of calcified nodules surrounded by amorphous fibrous tissue in a context of degeneration and chronic inflammation. Although CAT cases are increasingly reported, its clinical manifestation remains unclear. We aimed to conduct a narrative review of CAT and identify its clinical characteristics. We conducted a comprehensive literature search using PubMed, with the keyword “Cardiac Calcified Amorphous Tumor” to identify relevant articles. A total of 113 articles published between 1997 and 2022 were retrieved. The clinical features allowing for assess patient background, differences with and without end-stage renal disease (ESRD), symptom-related factors, risk factors for embolism caused by CAT, and features of CAT, such as shape, location, mobility, pathology, and treatment, were statistically analyzed in 106 criteria-matched cases. The mean patient age was 60.2 ± 18.6 years, with 45 men and 61 women. Of the data collected from 21 countries, 52 patients were from Japan. Mobile CAT was more common in the chronic renal failure group. Linear, club-shaped, and spindle-shaped CAT tended to be mobile and more common in the ESRD group as well as located in the mitral valve region. The shape, mobility, location, and underlying mechanism of CAT depended on the presence or absence of ESRD. The risk of embolism was considered high because mobile CAT was more common in the ESRD group, and CAT originated in the mitral valve region. Hence, early diagnosis based on periodic examination in patients with ESRD and aggressive surgical treatment are necessary.

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Infective calcified amorphous tumor on mitral valve and critical course of left ventricular rupture

Cited by 3 publications

References 6 publications

Cardiac calcified amorphous tumour: an unusual aetiology for recurrent cardioembolic strokes

Cardiac calcified amorphous tumour: an unusual aetiology for recurrent cardioembolic strokes

Multiple cerebral infarctions due to calcified amorphous tumor growing rapidly from an antecedent infection and decreasing rapidly by detachment of fibrin and antithrombotic drugs: a case report

Clinical Features of Cardiac Calcified Amorphous Tumor: A Narrative Review

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