Granulomatous Aortitis Presenting as an Acute Myocardial Infarction in Crohn’s Disease

Goldman, Melvin; Akl, Bechara F.; Mafi, Shayryar; Pastore, Lucia

doi:10.1161/01.cir.102.24.3023

Cited by 14 publications

(7 citation statements)

References 2 publications

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“…The age at presentation varies between case series, with a 14-patient case series by Pagni et al having an average age of 50.6 years, with no significant predilection for either gender [3]. TAMT may develop on an underlying diseased aorta due to underlying atheroma, aortic dissection, intimal flap, or aortitis [3, 5, 7, 9, 14]. Occasionally, TAMT may develop on what appears to be a normal underlying aorta.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of this rare entity has not been established or tested in case control trials or large meta-analyses. Many authors have reported resolution of clot and no further thromboembolism with anticoagulation with or without antiplatelet agents alone [3, 4, 6–8, 12, 13], while others have also had success with open surgical thrombectomy and postoperative anticoagulation [3, 6, 9, 10, 14], with the added benefit of addressing the organised thrombus component which is unlikely to respond to anticoagulation but at a risk of increased perioperative morbidity and mortality. A number of authors have, on the basis of trends in the literature, recommended early surgical over medical therapy.…”

Section: Discussionmentioning

confidence: 99%

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Thoracic Endovascular Aortic Repair in a Patient with Mobile Aortic Thrombosis

Lohrmann

Peters²

2014

Case Reports in Vascular Medicine

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A 58-year-old female presented with acute arterial insufficiency to her left leg. Following cardiovascular evaluation using multimodality imaging, it was discovered that she had mobile thoracic thrombi overlying a normal descending thoracic aorta which had also caused a splenic infarction. This patient was treated with unfractionated heparin for three days and underwent subsequent thoracic endovascular aortic repair (TEVAR) uneventfully with no subsequent complications at one-year followup. This case highlights the diagnostic and therapeutic challenges in treating patients with this uncommon challenging clinical scenario.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thoracic Endovascular Aortic Repair in a Patient with Mobile Aortic Thrombosis

Lohrmann

Peters²

2014

Case Reports in Vascular Medicine

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“…Many factors, such as atherosclerosis, dissection, trauma, malignancy, and coagulopathies, have been associated with aortic mural thrombi. Aortitis is a possible cause of aortic thrombus [3].…”

Section: Discussionmentioning

confidence: 99%

Successful management of huge floating thrombus within aortic arch in a patient with old myocardial infarction

Yoon

Jeong

Oho

et al. 2010

Journal of Cardiology Cases

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Few cases of a floating thrombus in an aorta have been reported without any systemic embolic complications. We report an unusual case of a huge floating thrombus (3 cm × 10 cm in size) in the aortic arch. The patient had a history of old myocardial infarction and had undergone successful percutaneous coronary intervention 16 years previously. The aortic thrombus was detected incidentally after echocardiography and computed tomography without any evidence of aortic dissection or distal embolization. The huge thrombus was removed successfully from the aortic arch by urgent surgery.

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“…Nearly all of them have clinical features that are absent from this case, allowing them to be ruled out. 7,[11][12][13][14][15][16][17][18][19][20][21] There is no history of ankylosing spondylitis, which typically involves the proximal aorta immediately above the sinuses of Valsalva. 7,11 There is no history of gastrointestinal symptoms; inflammation of the cartilage; recurrent orogenital ulcerations or skin lesions, which might suggest the presence of inflammatory bowel disease; relapsing polychondritis; Behçet's syndrome; or thromboangiitis obliterans.…”

Section: Diseases Affecting the Aorta And Its Major Branchesmentioning

confidence: 99%

“…7,11 There is no history of gastrointestinal symptoms; inflammation of the cartilage; recurrent orogenital ulcerations or skin lesions, which might suggest the presence of inflammatory bowel disease; relapsing polychondritis; Behçet's syndrome; or thromboangiitis obliterans. [12][13][14][15][16] Similarly, there is no history of keratitis or vestibuloauditory findings, which might suggest the presence of Cogan's syndrome, a rare disorder that is associated with aortitis in 10 percent of cases. 17 Systemic lupus erythematosus and rheumatoid arthritis have been associated with aortitis, but no features of this case are consistent with these diagnoses.…”

Section: Diseases Affecting the Aorta And Its Major Branchesmentioning

confidence: 99%

Case 39-2002

Rigby¹,

Fan²,

Mark³

2002

N Engl J Med

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A 35-year-old right-handed man was admitted to the hospital because of a persistent headache and deviation of the tongue.The patient had been in excellent health until about one month earlier, when a left-sided headache developed, with occasional bright spots in the left visual field, subjective fever, chilliness, and anorexia; he lost 5 kg of body weight at this time. The headache became severe and was not affected by nonsteroidal antiinflammatory agents, the patient's position, straining, or coughing. During this period, his tongue deviated to the left and caused drooling, although he had no dysphasia or dysphagia.One week before admission, the patient was seen at a community health center affiliated with this hospital, where he reported a transient sore throat. Ibuprofen and amoxicillin were prescribed, but his condition did not improve. A throat culture was negative for beta-hemolytic streptococci. He was admitted to this hospital.The patient was a native of Morocco and had immigrated to the United States one year before admission. He worked as a cook. He had smoked one pack of cigarettes daily for 10 years and used marijuana occasionally; he did not drink alcohol. There was no history of arthralgia, vision loss, rash, motor or sensory deficits, neck stiffness, nausea, vomiting, chest or abdominal pain, cough, head injury or other trauma, exposure to tuberculosis, or other illnesses in recent months.The temperature was 37.1°C, the pulse was 53, and the respirations were 20. The blood pressure was 125/ 70 mm Hg.On physical examination, the patient appeared well. No rash or definite lymphadenopathy was found, although some examiners palpated left cervical fullness; the neck was supple. One senior examiner noted slight temporal-artery tenderness, without thickening.On neurologic examination, the patient was alert and oriented, with intact speech and comprehension. His cranial-nerve functions were also intact, except for questionable left-sided facial weakness, definite leftward deviation of the tongue, and questionably decreased elevation of the palate on the left side; the gag reflex was preserved. Motor power was 5/5 throughout, without drift, and sensation of a light touch and a pinprick was normal. Coordination was also normal. The deep-tendon reflexes were ++ throughout, and the plantar responses were flexor.The urine was normal. The hematocrit was 39.5 percent; the white-cell count was 12,000 per cubic millimeter, with 67 percent neutrophils, 25 percent lymphocytes, 5 percent monocytes, 2 percent eosinophils, and 1 percent basophils; the platelet count was 545,000 per cubic millimeter; the mean corpuscular volume was 86 µm 3 ; and the erythrocyte sedimentation rate was 99 mm per hour. The prothrombin and partial-thromboplastin times were normal. The uric acid level was 1.7 mg per deciliter (101 µmol per liter), and the total protein level was 7.9 g per deciliter (albumin, 3.5 g per deciliter; globulin, 4.4 g per deciliter). The sodium level was 142 mmol per liter, the potassium level 4.6 mmol per liter, th...

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Granulomatous Aortitis Presenting as an Acute Myocardial Infarction in Crohn’s Disease

Cited by 14 publications

References 2 publications

Thoracic Endovascular Aortic Repair in a Patient with Mobile Aortic Thrombosis

Thoracic Endovascular Aortic Repair in a Patient with Mobile Aortic Thrombosis

Successful management of huge floating thrombus within aortic arch in a patient with old myocardial infarction

Case 39-2002

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