Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus
Background. Primary aortic thrombus is an uncommon entity and not frequently reported in the literature. Herein, we discuss the presentation and management of a patient with a primary thoracic mural thrombus. Case Summary. A 46-year-old female with past medical history of tobacco dependence presente...
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Wiley
2019-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/8132578 |
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| author | Ramy Mando Robert Gemayel Ashish Chaddha Julian J. Barbat Elvis Cami |
| author_facet | Ramy Mando Robert Gemayel Ashish Chaddha Julian J. Barbat Elvis Cami |
| author_sort | Ramy Mando |
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| description | Background. Primary aortic thrombus is an uncommon entity and not frequently reported in the literature. Herein, we discuss the presentation and management of a patient with a primary thoracic mural thrombus. Case Summary. A 46-year-old female with past medical history of tobacco dependence presented for low-grade fever and sudden onset, severe right upper quadrant abdominal pain with associated nausea and vomiting. Computed tomography (CT) revealed an intraluminal polypoid filling defect arising from the isthmus of the aorta projecting into the proximal descending aorta and findings consistent with infarction of the spleen and right kidney. Infectious, autoimmune, hematologic, and oncologic work-up were all unyielding. The patient was started on heparin and later transitioned to apixaban 5 mg twice a day and 81 mg of aspirin daily. She was also counseled regarding smoking cessation. Two months follow-up CT revealed resolution of the thrombus. Patient had no further thromboembolic complications. Discussion. We present a unique case of primary aortic thrombus. To our knowledge, this is the first reported case managed successfully with a NOAC. This diagnosis is one of exclusion and through work-up should be completed. Our aim is to raise awareness of this condition and successful management with apixaban in low-risk patients. |
| format | Article |
| id | doaj-art-aa15f577ce9d49c1a795977866673b46 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Case Reports in Cardiology |
| spelling | doaj-art-aa15f577ce9d49c1a795977866673b462025-02-03T05:58:54ZengWileyCase Reports in Cardiology2090-64042090-64122019-01-01201910.1155/2019/81325788132578Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic ThrombusRamy Mando0Robert Gemayel1Ashish Chaddha2Julian J. Barbat3Elvis Cami4Department of Internal Medicine, Beaumont Health System, Royal Oak, MI, USAMichigan State University College of Osteopathic Medicine, Lansing, MI, USADepartment of Cardiovascular Medicine, Beaumont Health System, Royal Oak, MI, USADepartment of Cardiovascular Medicine, Beaumont Health System, Royal Oak, MI, USADepartment of Cardiovascular Medicine, Beaumont Health System, Royal Oak, MI, USABackground. Primary aortic thrombus is an uncommon entity and not frequently reported in the literature. Herein, we discuss the presentation and management of a patient with a primary thoracic mural thrombus. Case Summary. A 46-year-old female with past medical history of tobacco dependence presented for low-grade fever and sudden onset, severe right upper quadrant abdominal pain with associated nausea and vomiting. Computed tomography (CT) revealed an intraluminal polypoid filling defect arising from the isthmus of the aorta projecting into the proximal descending aorta and findings consistent with infarction of the spleen and right kidney. Infectious, autoimmune, hematologic, and oncologic work-up were all unyielding. The patient was started on heparin and later transitioned to apixaban 5 mg twice a day and 81 mg of aspirin daily. She was also counseled regarding smoking cessation. Two months follow-up CT revealed resolution of the thrombus. Patient had no further thromboembolic complications. Discussion. We present a unique case of primary aortic thrombus. To our knowledge, this is the first reported case managed successfully with a NOAC. This diagnosis is one of exclusion and through work-up should be completed. Our aim is to raise awareness of this condition and successful management with apixaban in low-risk patients.http://dx.doi.org/10.1155/2019/8132578 |
| spellingShingle | Ramy Mando Robert Gemayel Ashish Chaddha Julian J. Barbat Elvis Cami Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus Case Reports in Cardiology |
| title | Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus |
| title_full | Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus |
| title_fullStr | Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus |
| title_full_unstemmed | Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus |
| title_short | Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus |
| title_sort | peripherally embolizing aortic thrombus the work up management and outcome of primary aortic thrombus |
| url | http://dx.doi.org/10.1155/2019/8132578 |
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