Abstract
Thrombus formation in a morphologically normal a aorta is a very rare event. A 50-year-old man with a his- s tory of chronic obstructive pulmonary disease, pre- e sented to the emergency department with pulmonary C edema. Transthoracic and transesophageal echocardio- t graphy revealed a highly mobile, pedunculated floating c thrombus in the descending thoracic aorta 3-4 cm dis- t tal to the origin of the left subclavian artery. The orig- t inal lumen of the aorta was almost obliterated by the thrombus. The aortic wall was free of any atheroma. Thrombolytic treatment was administered, but 3 hours d after starting streptokinase, he developed sudden and severe low-back pain accompanied by loss of lower-extremity pulses which were patent on admission. Cardiopulmonary arrest developed within an hour and the patient died despite resuscitation. The potential causes of aortic thrombus, the clinical spectrum that the patients may present, diagnostic methods, and therapeutic options are discussed.