A case of COVID-19 induced descending aortic thrombus and splenic infarctions

Abstract

Thromboembolic manifestations like pulmonary embolism and deep venous thrombosis are often reported and contribute to a significant mortality from acute and chronic COVID-19 infections. These phenomena are a result of the activation of the coagulation cascade by the COVID-19 induced inflammatory state. Majority of the thrombotic incidences are reported as a venous thrombosis but extremely rarely, arterial thrombi can be a manifestation of acute COVID-19 infection. The patient in our case report was an unvaccinated 47-year-old female who presented with fever, nausea, abdominal pain and vomiting. The imaging confirmed the presence of a non-occlusive thrombus in the descending aorta, multiple splenic infarctions and paralytic ileus. She was treated with systemic anti-coagulation. A hyper-coagulable workup was performed on the patient and no other risk factors that could contribute to a thrombus was identified.

Pediatric splenic infarction: Assessment of associated clinical conditions and outcome

“…In our cohort, two patients had SI secondary to a viral infection, one with SARS‐CoV‐2 (COVID‐19) and one with Epstein–Barr virus. Indeed, COVID‐19 infection frequently results in markedly dysregulated coagulation and heightened thrombotic risk which may lead to SI 13,14 . The highest incidence of pediatric thromboembolism is during the neonatal period, followed by another peak in adolescence 15 .…”

“…Indeed, COVID-19 infection frequently results in markedly dysregulated coagulation and heightened thrombotic risk which may lead to SI. 13,14 The highest incidence of pediatric thromboembolism is during the neonatal period, followed by another peak in adolescence. 15 Age distribution in our cohort does not seem to follow this trend.…”

Role of Multimodality Imaging in the Diagnostic work-up for Cardiac Amyloidosis

“…It is important to remember that patients with AL can also potentially have some myocardial tracer uptake and therefore, concomitant blood test for paraproteinemia is mandatory for accurate PYP result to rule out AL [26,27,28]. It is -interpretation of the Tc important that there are some exceptions in ATTR patients who may not exhibit classic myocardial tracer uptake, such as those with Ser77Tyr and P64L variants, and tissue diagnosis becomes the definitive method to establish diagnosis of ATTR in these patients [29,30,31,32].…”

Prevalence, Predictors and Diagnosis of Cardiac Amyloidosis in Patients with Aortic Stenosis

“…Tcpyrophosphate scintigraphy cannot diagnose AL. However, due to mild uptake of the tracer in AL, blood and urine protein electrophoresis and immunofi xation are simultaneously ordered to rule out the possibility of AL [28,29]. Positive Tc-pyrophosphate scan and absence of paraproteinemia establishes the diagnosis of ATTR.…”