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Case Reports
. 2023 Oct 23;15(10):e47539.
doi: 10.7759/cureus.47539. eCollection 2023 Oct.

Cocaine-Induced Ascending Aortic Thrombus

Paul Q Vu  1 , Siddharth Patel  2 , Prutha R Pathak  3 , Ashish K Basu  4
Affiliations
Case Reports

Cocaine-Induced Ascending Aortic Thrombus

Paul Q Vu et al. Cureus. .

Abstract

Aortic thrombosis without coexisting atherosclerosis is uncommon. Sometimes, aneurysms or dissections can predispose to thrombus in the abdominal or thoracic aorta. However, ascending aortic thrombus in a non-aneurysmal, non-atherosclerotic aorta is a rare occurrence. Although arterial thrombosis has been linked with its use, cocaine-associated thrombus of the ascending aorta has been rarely described. We report a young man with regular use of cocaine presenting with constant, burning, left-sided chest pain. He was found to have a large thrombus in a structurally normal ascending aorta. Medical management with therapeutic anticoagulation was started. Despite an interruption of anticoagulation treatment for two months due to non-compliance, the man survived. This unique case highlights the importance of various vascular complications associated with cocaine use, their early recognition, and their treatment.

Keywords: acute chest pain; aortic mural thrombus; ascending aorta; cocaine use; peripheral embolization.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Axial (A) and coronal (B) section of CT pulmonary angiogram. Prominent irregular mural thrombus measuring 2.5 x 1.2 cm in the ascending aortic arch (red arrow).
See this image and copyright information in PMC

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