Floating Thrombus in a Nonaneurysmal Ascending Aorta

Pradnya Brijmohan Bhattad, MD; Luigi Pacifico, DO,,,,Cardiovascular Medicine, Saint Vincent Hospital, UMass Chan Medical School, Worcester, Massachusetts,,,,The authors can be contacted via Pradnya Brijmohan Bhattad, MD, at pradnyabhattad20@gmail.com

Clinical Images

Floating Thrombus in a Nonaneurysmal Ascending Aorta

Pradnya Brijmohan Bhattad, MD; Luigi Pacifico, DO

Cardiovascular Medicine, Saint Vincent Hospital, UMass Chan Medical School, Worcester, Massachusetts

The authors can be contacted via Pradnya Brijmohan Bhattad, MD, at pradnyabhattad20@gmail.com

October 2023

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The finding of a thrombus in a nonaneurysmal aorta is a very rare entity with a potential for life-threatening complications such as risk for myocardial infarction and embolization to distal vascular beds.
Transesophageal echocardiogram (Videos 1-6) demonstrated a mobile echodense mass suggestive of a thrombus on the surface of ascending aorta, in a patient with atrial fibrillation. The aortic root and ascending aorta were normal in size and nonaneurysmal in this case.

The patient was already on therapeutic anticoagulation for atrial fibrillation and this was continued. Any further invasive management was deferred per patient preference.

Video 1