AN UNUSUAL CASE OF SYNCOPE DUE TO LARGE AORTIC VALVE THROMBI

Abstract

Section snippets

Background

Aortic valve thrombi are rare and life-threatening and can present in unusual ways. We present a case of a female in her 40s with a history of non-ischemic transient cardiomyopathy who presented with syncope.

Case

A 45-year-old female with a history of non-ischemic cardiomyopathy presented to our hospital for the sudden loss of consciousness while sitting on the toilet with the return of consciousness at the hospital. Physical examination was unremarkable. EKG and CT head had no acute abnormality; however, a chest CT angiogram noted an opacification in the ascending aorta, and a TTE showed a mobile aortic valve mass.

Decision-making

Intraoperative TEE confirmed a non-coronary cusp thrombus, which was removed via partial sternotomy. A cusp repair was completed with a bovine pericardial patch. Biopsy confirmed thrombus.

Conclusion

This case highlights the rare but critical nature of aortic valve thrombi. Early diagnosis, using imaging like echocardiography, CT, or MRI, is crucial due to significant morbidity and mortality risks. Treatment depends on thrombus size, location, and symptoms, often requiring surgery for large or symptomatic cases. Preventive measures are vital, including managing aortic valve disease and hypercoagulable conditions.

Document Type

Poster

Publication Date

4-7-2024

Publication Title

Journal of the American College of Cardiology

First Page

3742

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