Abstract
We report a rare case of thrombus formation in normal aorta causing myocardial infarction.
A 44-year-old man who had no prothrombotic risk factors presented with acute myocardial
infarction. Two-dimensional echocardiography revealed a hypoechoic homogenous mass
occupying the left coronary sinus and attached at the nonatherosclerotic aorta. The
mass seemed to cause myocardial infarction by occluding the left anterior descending
artery with oscillating movement according to the cardiac cycles. After surgical resection,
the histopathologic examination revealed the mass as an organized thrombus. This case
implies that an aortic mural thrombus can form in a nonatherosclerotic aorta without
any prothrombotic risk factors.
Résumé
Nous rapportons un cas rare de formation d’un thrombus dans une aorte normale causant
un infarctus du myocarde. Un homme de 44 ans qui n’avait pas de facteurs de risque
prothrombotiques a présenté un infarctus du myocarde aigu. L’échocardiographie bidimensionnelle
a révélé une masse hypoéchogène homogène qui occupait le sinus coronarien gauche et
était attachée à l’aorte non athéroscléreuse. La masse semble avoir provoqué l’infarctus
du myocarde en obstruant l’artère interventriculaire antérieure avec des mouvements
d’oscillation selon les cycles cardiaques. Après la résection chirurgicale, l’examen
histopathologique a révélé que la masse était un thrombus organisé. Ce cas montre
qu’un thrombus mural peut se former dans une aorte non athéroscléreuse chez les personnes
n’ayant aucun facteur de risque prothrombotique.
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References
- Atheromas of the thoracic aorta: clinical and therapeutic update.J Am Coll Cardiol. 2000; 35: 545-554
- Mural thrombus of the aorta: an important, frequently neglected cause of large peripheral emboli.Ann Surg. 1981; 194: 737-744
- Aortic mural thrombi in patients with inflammatory bowel disease: report of two cases and review of the literature.Inflamm Bowel Dis. 2004; 10: 430-435
- Mobile thrombus of the thoracic aorta: diagnosis and treatment in 9 cases.Ann Vasc Surg. 2002; 16: 714-722
Article info
Publication history
Published online: November 18, 2013
Accepted:
October 21,
2013
Received:
August 29,
2013
Footnotes
See page 464.e7 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
