Mitral Annular Calcification as a Cause of Mitral Stenosis
- Wed, 2/23/11 - 11:04am
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Introduction
The mitral annulus is a ring-like fibrous structure by which the leaflets of the mitral valve attach to the myocardium. Over time, noninflammatory degenerative changes, referred to as mitral annular calcification (MAC), may develop. MAC is a process involving calcium and lipid deposition and may interfere with the normal functioning of the mitral apparatus.1,2 Although MAC has been frequently reported as a cause of mitral regurgitation,2,3 usually of no clinical significance, it has rarely been described as a cause of clinically significant mitral stenosis. We report two symptomatic patients who presented with congestive heart failure caused by mitral stenosis secondary to advanced MAC and provide a review of the literature concerning this clinical entity.
Case Presentations
Patient 1
Alcoholic Ketoacidosis—Underrecognized Cause of Metabolic Acidosis in the Elderly
- Fri, 2/12/10 - 1:45pm
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Introduction
The Substance Abuse & Mental Health Services Administration (SAMHSA) reported that substance abuse among adults age 60 years and older is a rapidly growing health problem. The report also stated that in 2000, 17% of Americans age 65 and older had problems with prescription drug and alcohol abuse.1 Most elderly people with alcohol abuse problems have a history of early-life alcohol abuse. However, a significant proportion start drinking later in life in response to traumatic life events such as the death of a loved one, loneliness, pain, insomnia, and retirement. This
