title: Mural thrombus in the normal-appearing descending thoracic aorta of a chronic smoker.
abstract: Thrombus formation in an atherosclerotic or aneurysmal descending thoracic aorta is a well-described, frequently encountered vascular condition. In comparison, thrombus formation in a normal-appearing descending thoracic aorta is reported far less often. We describe the case of a 46-year-old woman who had splenic and renal infarctions secondary to embolic showers from a large, mobile thrombus in a morphologically normal proximal descending thoracic aorta. After the patient underwent anticoagulation, stent-grafting, and surgical bypass to correct an arterial blockage caused by the stent-graft, she resumed a relatively normal life. In contrast with other cases of a thrombotic but normal-appearing descending thoracic aorta, this patient had no known malignancy or systemic coagulative disorders; her sole risk factor was chronic smoking. We discuss our patient's case and review the relevant medical literature, focusing on the effect of smoking on coagulation physiology.
authors.affiliation: Department of Cardiology (Dr. Habib), Seton Hall University/Saint Michael's Medical Center, Newark, New Jersey 07102; Department of Family Medicine (Dr. Hsu), University of Massachusetts, Worcester, Massachusetts 01655; and Department of Cardiology (Dr. Daoko and Ms Winchell), Memorial Hospital, York, Pennsylvania 17405.
authors.forename: Habib
authors.initials: H
authors.lastname: Habib
authors.affiliation: Department of Cardiology (Dr. Habib), Seton Hall University/Saint Michael's Medical Center, Newark, New Jersey 07102; Department of Family Medicine (Dr. Hsu), University of Massachusetts, Worcester, Massachusetts 01655; and Department of Cardiology (Dr. Daoko and Ms Winchell), Memorial Hospital, York, Pennsylvania 17405.
authors.forename: Judy
authors.initials: J
authors.lastname: Hsu
authors.affiliation: Department of Cardiology (Dr. Habib), Seton Hall University/Saint Michael's Medical Center, Newark, New Jersey 07102; Department of Family Medicine (Dr. Hsu), University of Massachusetts, Worcester, Massachusetts 01655; and Department of Cardiology (Dr. Daoko and Ms Winchell), Memorial Hospital, York, Pennsylvania 17405.
authors.forename: Patricia Jo
authors.initials: PJ
authors.lastname: Winchell
authors.affiliation: Department of Cardiology (Dr. Habib), Seton Hall University/Saint Michael's Medical Center, Newark, New Jersey 07102; Department of Family Medicine (Dr. Hsu), University of Massachusetts, Worcester, Massachusetts 01655; and Department of Cardiology (Dr. Daoko and Ms Winchell), Memorial Hospital, York, Pennsylvania 17405.
authors.forename: Joseph
authors.initials: J
authors.lastname: Daoko
mesh_terms: D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000175:diagnosis* / Q000209:etiology; D002908:Chronic Disease; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed
keywords: Anticoagulants/therapeutic use; aorta, thoracic/pathology/radiography/surgery; aortic diseases/diagnosis/etiology/therapy; diagnostic imaging; embolism/diagnosis/etiology; endothelium, vascular/physiology; risk factors; smoking/physiopathology; thrombosis/diagnosis/etiology/surgery/therapy