Response to Letter Regarding Article, "MacCallum Plaque Causes Acute Myocardial Infarction in a Young Man".

We would like to thank Dr Tuncez for his comments on the reported case with rheumatic heart disease complicated by MacCallum plaques.1 The patient first presented with exertional dyspnea, but not chest pain, to the outpatient clinics. The physical examination disclosed diastolic rumbling murmur, and grade III/VI systolic murmur, as well. The following transthoracic echocardiogram showed aortic valve thickening, mild mitral stenosis, and severe mitral regurgitation with a mean transvalvular pressure gradient of 16.4 mm Hg …