Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
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Clin. Appl. Thromb. Hemost. · Oct 2008
Case ReportsFatal giant aortic thrombus presenting with pulmonary edema in a patient with chronic obstructive pulmonary disease.
Thrombus formation in a morphologically normal a aorta is a very rare event. A 50-year-old man with a history of chronic obstructive pulmonary disease, presented to the emergency department with pulmonary edema. Transthoracic and transesophageal echocardiography revealed a highly mobile, pedunculated floating thrombus in the descending thoracic aorta 3-4 cm distal to the origin of the left subclavian artery. ⋯ Thrombolytic treatment was administered, but 3 hours after starting streptokinase, he developed sudden and severe low-back pain accompanied by loss of lower-extremity pulses which were patent on admission. Cardiopulmonary arrest developed within an hour and the patient died despite resuscitation. The potential causes of aortic thrombus, the clinical spectrum that the patients may present, diagnostic methods, and therapeutic options are discussed.