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Coronary sinus thrombosis: insights from a comprehensive literature review
Chenlong Yi1,2
1Department of Cardiovascular Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368 Hanjiang Middle Road, Yangzhou, 225001, Jiangsu Province, China. yichenlong_001@163.com.
Insights
Coronary sinus thrombosis (CST) is a rare but serious condition. Early recognition and multidisciplinary care are crucial for improving patient outcomes and managing this underrecognized disease.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Coronary sinus thrombosis (CST) is a rare and severe condition often underrecognized in clinical practice.
- Cases can present acutely with high mortality or insidiously, leading to delayed diagnosis and complications.
Purpose of the Study:
- To review the pathophysiology, clinical presentations, diagnostic challenges, and management of coronary sinus thrombosis.
- To highlight the association of CST with persistent left superior vena cava (PLSVC) and the role of imaging.
Main Methods:
- Literature review focusing on pathophysiology, clinical features, diagnostic modalities, and treatment strategies for CST.
- Emphasis on imaging techniques including Echocardiography, CT, MRI, and Venography.
Main Results:
- CST presents with diverse clinical manifestations, ranging from acute to insidious courses.
- Imaging modalities are crucial for diagnosis, and anticoagulation is the primary treatment, with surgery for refractory cases.
Conclusions:
- Enhanced understanding of CST pathophysiology and clinical presentation is vital for early recognition.
- Multidisciplinary care, tailored interventions, and vigilant follow-up are essential for improving outcomes in CST.
Abstract:
Coronary sinus thrombosis (CST) is a rare and severe disease that remains underrecognized in clinical practice. Most documented cases fall within the acute category, with non-specific symptoms, rapid progression, and a high mortality rate. In contrast, some cases follow an insidious course, leading to the formation of partial or incomplete thrombi that may not cause immediate death but can progress to severe complications over time. This review study the pathophysiology, clinical presentations, diagnostic challenges, and the association with persistent left superior vena cava (PLSVC), emphasizing the utility of imaging modalities such as Echocardiography, Computed Tomography, Magnetic Resonance Imaging and Venography. For management, anticoagulation remains the cornerstone of treatment for CST, with surgical thrombectomy reserved for severe or refractory cases. Post-treatment follow-up is highlighted as essential for monitoring recurrence and managing complications. In brief, the aim of this review is to enhance the understanding of CST and improve clinical outcomes through early recognition, tailored interventions, and multidisciplinary care.
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