Aortic Thrombi in a patient with HIT Syndrome Khalaf HH, MD; Ibrahim MF, FRCS(C-Th) ; Al-Murayeh MA , FACC . Cardiac Center, King Fahad Medical City, Riyadh, Saudi Arabia.

47-years-old female who had radical mastectomy for carcinoma of breast. She is not known diabetic or hypertensive . She received heparin for DVT prophylaxis during her hospital stay . She presented two weeks later with right middle cerebral artery infarction with hemorrhagic transformation. She had pulmonary embolism as confirmed by spiral chest CT . She was diagnosed as HIT syndrome. Transesophageal echocardiogram was done in a search for a cardiac source of emboli which revealed normal heart in structure and function . There were two highly mobile echo-dense masses within the lumen of the distal aortic arch ( Figure 1) , also another mass in the proximal descending thoracic aorta ( Figures 2a, 2b ) . The wall of the aorta was otherwise normal, the three masses as consistent with thrombi.

Correspondence:

Dr. Mushabab Ayedh Al-Murayeh Head, Cardiology Department Armed Forces Hospital Southern Region P.O. Box 101, Khamis Mushayt, Saudi Arabia

E-mail: [email protected] Telephone +966 7 250-0001 Ext 2504 Fax: +966 7 250-0001 Ext 2538 (Figure 1). Short axis view of the distal aortic arch showing two large intraluminal thrombi.

(Figure 2a). Short axis view of the proximal descending thoracic aorta showing one large intraluminal thrombus.

(Figure 2b). Long axis view of the proximal descending thoracic aorta showing one large intraluminal thrombus.