title: Asymptomatic aortic mural thrombus in a minimally atherosclerotic vessel.
abstract: Aortic mural thrombi in a normal (non-aneurysmal or minimally atherosclerotic) vessel are an uncommon condition. They are usually located in the descending aorta and, less frequently, in the aortic arch or in the abdominal aorta. The typical clinical presentation is the appearance of symptoms/signs of peripheral arterial embolization, such as lower limb or visceral ischaemia, but these can also be accidentally found in asymptomatic patients. We report the case of a 40-year old man with untreated hypertension and dyslipidaemia admitted to hospital for atypical chest pain associated with an elevation in high-sensitivity troponin T with normal creatine kinase isoenzime MB creatine kinase isoenzyme. Elektrocardiogram (EKG) and transthoracic echocardiography were non-diagnostic; in order to exclude an aortic dissection, a gated chest computed tomography was performed and showed an aortic thrombus on a minimally atherosclerotic wall. Then, a transoesophageal echocardiography confirmed an aortic floating thrombus (7 × 4 mm). Cardiac surgeons advised against surgery and therapy with antiplatelet, low molecular weight heparin, β-blocker, antihypertensive and lipid-lowering drugs was initiated. A complete resolution of the thrombus was observed at the 12-day tomographic control.
authors.affiliation: Department of Health Science, Milano-Bicocca University, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Maloberti
authors.affiliation: Department of Cardiology I, 'A.De Gasperis', Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
authors.affiliation: Department of Cardiology IV, 'A.De Gasperis', Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: De Chiara
authors.affiliation: Department of Health Science, Milano-Bicocca University, Milan, Italy Department of Cardiology IV, 'A.De Gasperis', Ospedale Niguarda Ca' Granda, Milan, Italy cristina.giannattasio@unimib.it cristina.giannattasio@ospedaleniguarda.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannattasio
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000175:diagnosis / Q000188:drug therapy; D001027:Aortography / Q000379:methods; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000175:diagnosis / Q000188:drug therapy; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D058226:Plaque, Atherosclerotic; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents
keywords: Aortic thrombus; Thoracic aorta; Transoesophageal echocardiography