title: Calcific aortic valve and spontaneous embolic stroke: a review of literature.
abstract: Aortic valve calcification is common in the elderly and in patients with congenital bicuspid aortic valve but unlike calcific mitral valve disease it is not a well recognized risk factor for stroke. Although autopsy studies have revealed evidence of systemic embolism in one-third of cases with calcific aortic valves, there is conflicting data from larger clinical studies examining the association between calcific aortic valve and stroke. There are only 8 reported cases of symptomatic stroke from spontaneous cerebral thromboembolism associated with calcific aortic valve in the literature. Computerized tomography (CT) angiography and CT without contrast are modalities of choice to diagnose calcific embolism, while MRI may be useful in delineating the extent of ischemia. Ideal management strategy, the role of antiplatelet therapy, anticoagulation or recommendations for valve replacements are poorly defined. We present a focused literature review on this topic.
authors.affiliation: Division of Cardiology, Wayne State University, Detroit, MI-48201, USA.
authors.forename: Vipin
authors.initials: V
authors.lastname: Khetarpal
authors.forename: Nitin
authors.initials: N
authors.lastname: Mahajan
authors.forename: Ramesh
authors.initials: R
authors.lastname: Madhavan
authors.forename: Sachin
authors.initials: S
authors.lastname: Batra
authors.forename: Prashanth
authors.initials: P
authors.lastname: Mopala
authors.forename: Amit
authors.initials: A
authors.lastname: Sagar
authors.forename: Praveen
authors.initials: P
authors.lastname: Rapolu
authors.forename: Sharad
authors.initials: S
authors.lastname: Nangia
authors.forename: Luis
authors.initials: L
authors.lastname: Afonso
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D002114:Calcinosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000592:standards; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D015897:Comorbidity; D003952:Diagnostic Imaging / Q000592:standards; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors