Mobile thoracic aortic thrombus in a methamphetamine user after cardiac arrest.

A 45-year-old woman was admitted to the hospital after cardiac arrest (ventricular fibrillation); she had been defibrillated and intubated in the field. Electrocardiography revealed a pattern of inferior injury, but echocardiography showed no regional wall-motion abnormalities and a normal left ventricular ejection fraction. Our hypothermia protocol was instituted and cardiac catheterization was planned; however, contrast computed tomography of the chest revealed a 4.6-cm thrombus in the descending thoracic aorta (Figs. 1 and 2). There was no intimal tear or dissection. Transesophageal echocardiography revealed a mobile aortic thrombus attached distal to the left subclavian artery (Figs. 3 and 4). There was no intracardiac shunt or thrombus. Endovascular aortic repair with a stent-graft successfully Images in Cardiovascular Medicine