title: Calcific retinal embolism as an indicator of severe unrecognised cardiovascular disease.
abstract: OBJECTIVE
  To describe the association between calcific retinal embolism (CRE) and cardiac valve stenosis.
  
  
  METHODS
  Retrospective chart review of patients with clinical criteria for CRE.
  
  
  METHODS
  24 patients with CRE who underwent two dimensional echocardiography between 1976 and 1998.
  
  
  RESULTS
  Nine patients (38%) had calcific valve stenosis, which was haemodynamically severe in five patients (four aortic and one mitral), four of whom had no cardiac symptoms. Six patients underwent surgical intervention (aortic valve replacement in three patients, mitral and aortic valve replacement in one patient, removal of calcific cardiac pseudotumour in one patient, and carotid endarterectomy in one patient).
  
  
  CONCLUSIONS
  CRE may be the presenting feature of otherwise asymptomatic, clinically important underlying cardiovascular disease and, in particular, haemodynamically severe calcific valve stenosis.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ramakrishna
authors.forename: J F
authors.initials: JF
authors.lastname: Malouf
authors.forename: B R
authors.initials: BR
authors.lastname: Younge
authors.forename: H M
authors.initials: HM
authors.lastname: Connolly
authors.forename: F A
authors.initials: FA
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D004617:Embolism / Q000209:etiology*; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D015356:Retinal Artery Occlusion / Q000209:etiology*; D012189:Retrospective Studies; D014463:Ultrasonography