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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
PubMed
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.

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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.

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  • 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.