MacCallum Plaque Causes Acute Myocardial Infarction in a Young Man

A 27-year-old man died suddenly of acute extensive myocardial infarction. The patient was healthy with no known systemic diseases. In October 2013, he visited our cardiovascular outpatient department because of progressive shortness of breath. Physical examination showed grade III systolic murmur at the apex. A transesophageal echocardiogram revealed diffuse thickening of the mitral valve with severe mitral regurgitation and nodular lesions at the posterior wall of the left atrium and posterior mitral leaflet (Movie I in the online-only Data Supplement). Surgical intervention with mechanical mitral valve replacement and resection of intra-atrial tumors was uneventful. The pathology of the intracardiac tumor showed papillary fibroelastoma, and the mitral valve showed fibrosis and myxomatous degeneration. After surgery, the patient was free of symptoms. Unfortunately, chest tightness was noted 3 months later. An ECG showed diffuse …