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Related Experiment Videos

Aortic mural thrombus presenting as pseudovasculitis

A T Sprabery1, K Newman, K M Lohr

  • 1Department of Medicine, University of Tennessee, Memphis 38163.

Chest
|July 1, 1994
PubMed
Summary
This summary is machine-generated.

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Aortic thrombus can mimic vasculitis, leading to misdiagnosis. This case highlights how a mobile aortic thrombus caused symptoms initially attributed to polyarteritis nodosa.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Diagnostic Imaging

Background:

  • Persistent low-grade fever and abdominal complaints can present diagnostic challenges.
  • Vasculitis, such as polyarteritis nodosa, is a consideration in patients with systemic inflammatory symptoms.

Observation:

  • A 50-year-old woman presented with persistent symptoms following splenic infarct.
  • Initial arteriography and clinical presentation suggested polyarteritis nodosa, leading to corticosteroid treatment.
  • Subsequent arteriography and transesophageal echocardiography revealed an aortic arch thrombus.

Findings:

  • The patient's symptoms were ultimately attributed to an embolic source, specifically a pedunculated mobile thrombus in the aortic arch.
  • The clinical picture initially mimicked vasculitis, a condition termed 'pseudovasculitis' in this context.

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Implications:

  • This case underscores the importance of considering embolic phenomena, particularly aortic thrombus, in the differential diagnosis of vasculitis.
  • Accurate diagnosis through advanced imaging like TEE is crucial to avoid inappropriate treatments such as long-term corticosteroid therapy.
  • Recognizing pseudovasculitis can prevent unnecessary immunosuppression and guide appropriate anticoagulation therapy.