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Case Reports in Cardiology
Volume 2013, Article ID 748241, 2 pages
Case Report

Caseous Necrosis of Mitral Annulus: A Rare Cause of Stroke

University Hospital of Bordeaux, Cardiologic Hospital Haut-Lévêque, 33600 Pessac, France

Received 12 March 2013; Accepted 15 April 2013

Academic Editors: M. Ferrari, A. Movahed, J. Peteiro, and K. Roberts-Thomson

Copyright © 2013 Jérôme Corre et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The current report describes a rare case of a caseous necrosis presenting as a pseudotumor in ventricle, revealed by stroke. Cerebral MRI, showing multiples lacunes, evocates a cardioembolic mechanism. Transthoracic and transesophageal echocardiography demonstrate a large hyperechogenic mass fixed to the posterior mitral valve and annulus while thoracic tomography revealed a fully calcified lesion, at the mitral annulus, evocative of caseus necrosis. Medical therapy was preferred (anticoagulation), because of her age and the decaying nature of surgery.