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A Devastating Floating Aortic Thrombus and Ketosis-Prone Diabetes.

Ricardo A Serrano¹, Lavinia Kolarczyk¹, Daniel J Rosenkrans²

¹Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, USA.

|October 9, 2023

Summary

Ketosis-prone diabetes (KPD) may contribute to aortic thrombus formation and embolization. This case highlights KPD

Keywords:

aortic diseases aortic thrombosis diabetic keto acidosis ketosis prone diabetes systemic anticoagulation

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Area of Science:

Cardiology
Endocrinology
Vascular Medicine

Background:

Ketosis-prone diabetes (KPD) is a distinct subtype of diabetes mellitus.
KPD presents with severe hyperglycemia and diabetic ketoacidosis.
Inflammation from uncontrolled hyperglycemia is a key feature of KPD.

Observation:

A middle-aged patient with KPD and diabetic ketoacidosis developed a mobile thrombus in the distal aortic arch.
The patient exhibited limited atherosclerosis and no signs of thrombophilia.
Catastrophic embolic complications arose from the aortic thrombus.

Findings:

KPD and associated inflammation likely contributed to the aortic thrombus formation.
Endothelial dysfunction and prothrombotic pathway activation are potential mechanisms.
The exact pathogenesis of mobile aortic thrombus in KPD requires further investigation.

Implications:

This case underscores the potential cardiovascular risks associated with KPD.
Optimal management strategies for mobile aortic thrombus in KPD remain debated.
Further research is needed to clarify the link between KPD, inflammation, and aortic thrombosis.