An uncommon case of thrombosis of ascending aorta diagnosed by transesophageal echocardiography

Abstract

The most common sites for arterial thrombosis depend on the patient’s age and the type of thrombosis. The coronary artery is the commonest site, which can lead to a heart attack, and the middle cerebral, internal carotid artery, which can lead to stroke. Atherosclerosis is the most common cause of arterial thrombosis. Other risk factors are old age, smoking, obesity, overweight, an unhealthy diet, lack of exercise, high blood pressure, high cholesterol, diabetes, COVID-19 infection, and inherited factors. Risk factors in adults less than 60 years of age and old adults could be different. Thrombosis of other arteries can occur due to underlying systemic diseases. Aortic thrombosis is less common, and ascending aorta thrombosis is the least common because of the high velocity and caliber of blood flowing through it. We present a case of a patient, less than 60 years of age, with arterial thrombosis at an uncommon site in the ascending aorta, who needed Transesophageal echocardiography (TEE) for diagnosis as CT angiogram(CTA) and transthoracic echocardiography(TTE) were negative. The case highlights the importance of paying more attention to uncommon sites of thrombosis and using more conventional modalities to diagnose aortic thrombosis.