Large thrombus in the ascending aorta successfully treated by thrombolysis--an unusual cause of acute massive myocardial infarction

H Ito, Ito H, K. Takahashi, Takahashi K, H. Sasaki, Sasaki H, Akiho H, H Akiho, Y Katahira, Katahira Y, Saito H, H Saito, Ishibashi T, T Ishibashi
Japanese circulation journal · 2001 · doi:10.1253/jcj.65.572 · PMID:11407743
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⚙ AI-generated summary by claude@2026-07, 2026-07-16 ⓘ

This case report describes the successful thrombolytic treatment of a large ascending aortic thrombus that caused acute myocardial infarction by obstructing the left coronary artery.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-16 · read from full text ⓘ

This paper reports a 52-year-old woman with acute massive myocardial infarction associated with a large, mobile thrombus in the ascending aorta near the left coronary artery orifice. Using cardiac angiography, the left coronary artery could not be visualized, and due to severe hemodynamic impairment the authors performed immediate intraarterial counterpulsation and intravenous thrombolysis; the thrombus dissolved within 1 hour and recanalization of the left coronary artery was achieved without serious systemic thromboembolism. The case limitation is that this is a single case report and cannot establish generalizable mechanisms or outcomes. The patient reported use of hormone supplement therapy and contraceptive pills for endometriosis, making the paper relevant to endometriosis via the cited treatment context.

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Abstract

A 52-year-old woman suffered from acute massive myocardial infarction in association with a large thrombus in the ascending aorta. She was a moderate smoker and was taking hormone supplement therapy for menopausal hormone insufficiency and the contraceptive pill for endometriosis. Cardiac angiography revealed a large mobile filling defect close to the orifice of the left coronary artery, but the left coronary artery could not be visualized. Her hemodynamic condition was impaired so greatly that intraarterial counterpulsation and intravenous thrombolysis was immediately performed. The thrombus dissolved in 1 h and recanalization of the left coronary artery was achieved without serious systemic thromboembolism. She has been doing well with no cardiac events for 7 years. This is the second report of a large thrombus in ascending aorta being the cause of acute myocardial infarction in the whole territory of the left coronary artery, and the first to diagnose such a thrombus antemortem and treat it successfully.
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Case Report Large Thrombus in the Ascending Aorta Successfully Treated by Thrombolysis An Unusual Cause of Acute Massive Myocardial Infarction 2001 Volume 65 Issue 6 Pages 572-574 Details Abstract A 52-year-old woman suffered from acute massive myocardial infarction in association with a large thrombus in the ascending aorta. She was a moderate smoker and was taking hormone supplement therapy for menopausal hormone insufficiency and the contraceptive pill for endometriosis. Cardiac angiography revealed a large mobile filling defect close to the orifice of the left coronary artery, but the left coronary artery could not be visualized. Her hemodynamic condition was impaired so greatly that intraarterial counterpulsation and intravenous thrombolysis was immediately performed. The thrombus dissolved in 1 h and recanalization of the left coronary artery was achieved without serious systemic thromboembolism. She has been doing well with no cardiac events for 7 years. This is the second report of a large thrombus in ascending aorta being the cause of acute myocardial infarction in the whole territory of the left coronary artery, and the first to diagnose such a thrombus antemortem and treat it successfully. (Jpn Circ J 2001; 65: 572 - 574) © 2001 THE JAPANESE CIRCULATION SOCIETY Favorites & Alerts Recently viewed articles Successor

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Condition tags

endometriosis

MeSH descriptors

Aorta Coronary Thrombosis Thrombolytic Therapy Aorta Coronary Angiography Coronary Thrombosis Coronary Thrombosis Coronary Thrombosis Disease-Free Survival Female Humans Middle Aged Myocardial Infarction Myocardial Infarction Treatment Outcome

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