Canadian Journal of Cardiology
Case Report| Volume 30, ISSUE 4, P464.e5-464.e7, April 2014

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Pedunculated Aortic Mural Thrombus Attached at Unusual Site of Normal Aorta Presenting With Acute Myocardial Infarction

Published:November 18, 2013DOI:


      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.


      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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