title: Extreme clinical presentations of venous stasis: coronary sinus thrombosis.
abstract: Sixty six year old male with history of heart failure was admitted for dysphagia, weight loss. CT scan chest revealed diffuse oesophageal wall thickening. Upper endoscopy, oesophagogram confirmed diagnosis of achalasia. TTE revealed severely reduced biventricular systolic function with LVEF 10%; PASP 75-80 mmHg. Parasternal long views showed dilated coronary sinus with a visible, mobile 2.0 cm thrombus. Pro-thrombotic workup was negative. Coronary sinus thrombosis has been identified as a rare complication to invasive cardiac procedures causing damage to coronary sinus endothelium and in hypercoagulable states.Typically acute thrombosis presents with chest pain, dynamic ECG changes, but chronic development does not present with ischaemic signs due to formation of efficient collateral circulation. We present a case report of stable primary coronary sinus thrombus incidentally diagnosed, secondary to chronic venous stasis in coronary circulation. Currently, there are no guidelines to assist physicians in long term management of such patients and thus warrants further investigations.
authors: Amit
authors: A
authors: Kachalia
authors: Panagiotis
authors: P
authors: Sideras
authors: Mian
authors: M
authors: Javaid
authors: Sethu
authors: S
authors: Muralidharan
authors: Pilar
authors: P
authors: Stevens-Cohen
mesh_terms: D000368:Aged; D054326:Coronary Sinus; D003328:Coronary Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D004452:Echocardiography; D004931:Esophageal Achalasia / Q000150:complications; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D018487:Ventricular Dysfunction, Left / Q000150:complications*; D018497:Ventricular Dysfunction, Right / Q000150:complications*