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Multiple aortic thrombi associated with protein C and S deficiency
A Onwuanyi1, R Sachdeva, K Hamirani
1Division of Cardiology, Queens Hospital Center, Mount Sinai School of Medicine, Jamaica, NY 11432, USA. onwuaa01@doc.mssm.edu
Mayo Clinic Proceedings
|March 13, 2001
Summary
A rare case of arterial thromboembolism was linked to deficiencies in protein C and S plasma proteins. Transesophageal echocardiography aided in diagnosing multiple thrombi and guiding successful anticoagulation treatment.
Area of Science:
- Cardiology
- Hematology
- Vascular Medicine
Background:
- Arterial thromboembolism, including aortic thrombus, is often associated with atherosclerosis.
- Deficiencies in protein C and S, crucial inhibitors of the clotting system, can predispose individuals to thrombotic events.
Observation:
- A patient presented with mesenteric artery thromboembolism and subsequently found to have multiple thrombi in the aorta and right heart chambers via transesophageal echocardiography.
- Diagnostic workup revealed a combined deficiency of protein C and S plasma proteins.
Findings:
- This case represents the first reported instance of mural thrombus in the thoracic aorta associated with a combined deficiency of protein C and S.
- Successful treatment was achieved using systemic anticoagulation therapy.
Implications:
- This case highlights the importance of considering inherited thrombophilias, such as protein C and S deficiency, in patients with unusual arterial thromboembolism.
- Transesophageal echocardiography is a valuable diagnostic tool for evaluating complex arterial thromboembolic disease.
- Early identification and management of protein C and S deficiencies are critical for preventing recurrent thrombotic events.