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[Difficulties in diagnosing an aortic arch thrombus]
M Hoffmann1, A Talaszka, A Liesse
1Service de néphrologie et d'hémodialyse, centre hospitalier de Roubaix, hôpital V.-Provo, boulevard Lacordaire, BP 359, 59056 Roubaix, France. maxime.hoffmann@free.fr
La Revue De Medecine Interne
|December 17, 2002
Summary
A rare aortic arch thrombus, often missed, can cause widespread arterial embolism. Prompt diagnosis and anticoagulant therapy can lead to complete resolution, preventing serious complications.
Area of Science:
- Cardiology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Thrombosis of the aortic arch is an infrequent cause of peripheral arterial embolism.
- It is often underdiagnosed, leading to delayed treatment and potential complications.
Observation:
- A case presented with atypical polyarteritis nodosa, later suspected to involve an aortic arch thrombus due to disseminated arterial embolism.
- Initial transthoracic echocardiography was inconclusive; diagnosis required transesophageal echocardiography, CT, and MRI.
- The aortic arch thrombus resolved completely after six months of anticoagulant therapy.
Findings:
- Transesophageal echocardiography, CT, and MRI are crucial for diagnosing aortic arch thrombus.
- Oral anticoagulant therapy is effective in resolving aortic arch thrombus.
- Early diagnosis is vital to prevent detrimental functional consequences.
Implications:
- Clinicians should consider aortic arch thrombus in cases of unexplained peripheral embolic events.
- Advanced imaging techniques are essential for accurate diagnosis.
- Timely intervention with anticoagulation can prevent severe outcomes and improve patient prognosis.