A Floating Thrombus in Sinus of Valsalva Complicated with Cardiogenic Shock in a Patient with Plasminogen Activator Inhibitor 1 4G/5G Polymorphism

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 28; no. 8; pp. E164 - E167
• Main Authors: Saygi, Serkan, Alioglu, Emin, Karabulut, Mehmet Nuri, Turk, Ugur Onsel, Kirilmaz, Bahadir, Tuzun, Nurullah, Sahin, Fahri, Kosova, Buket, Tengiz, Istemihan
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-09-2011
• Subjects: angiography; Aortic Diseases - complications; Aortic Diseases - diagnostic imaging; Aortic Diseases - genetics; cardiogenic shock; Echocardiography; Humans; Male; mass; Middle Aged; Plasminogen Activator Inhibitor 1 - genetics; Polymorphism, Genetic; Shock, Cardiogenic - etiology; sinus of Valsalva; Sinus of Valsalva - diagnostic imaging; TEE; Thrombosis - complications; Thrombosis - diagnostic imaging; Thrombosis - genetics; thrombus
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/j.1540-8175.2011.01432.x

Thrombus in sinus of Valsalva is unusual reason for acute myocardial infarction. We demonstrated a case with floating thrombus in sinus of Valsalva obstructing the right coronary ostium intermittently, and causing cardiogenic shock. The patient was diagnosed with multiplane transesophageal echocardiography and treated successfully with surgical removal of mass. A homozygote polymorphism of plasminogen activator inhibitor (PAI) 1 4G/5G was found. This is the first report demonstrating a patient with PAI 1 polymorphism and thrombus of Valsalva complicated with cardiogenic shock. (Echocardiography 2011;28:E64‐E167)
We demonstrated a case with floating thrombus in sinus of Valsalva obstructing the right coronary ostium intermittently, and causing cardiogenic shock. The patient was treated successfully with surgical removal of mass. A homozygote polymorphism of plasminogen activator inhibitor (PAI) 1 4G/5G was found. This is the first report demonstrating a patient with PAI 1 polymorphism and thrombus of Valsalva complicated with cardiogenic shock.