American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Medical Case Reports. 2017, 5(4), 94-100
DOI: 10.12691/ajmcr-5-4-5
Open AccessCase Report

Complex Aortic Plaques; an Emerging Source of Life Threatening Cardioembolic Ischemic Infarction

Noman Ahmed Jang Khan1, , Saad Ullah1 and Joshan Suri1

1Department of Internal Medicine, Temple University/Conemaugh Memorial Hospital, Johnstown, PA, USA

Pub. Date: May 16, 2017

Cite this paper:
Noman Ahmed Jang Khan, Saad Ullah and Joshan Suri. Complex Aortic Plaques; an Emerging Source of Life Threatening Cardioembolic Ischemic Infarction. American Journal of Medical Case Reports. 2017; 5(4):94-100. doi: 10.12691/ajmcr-5-4-5


Cardioembolic ischemic infarction, the most severe subtype of ischemic strokes account for approximately 15-30 % of all ischemic strokes. The most common associated disorders include atrial fibrillation, recent myocardial infarction, dilated cardiomyopathy, mechanical prosthetic valve, and mitral rheumatic stenosis. Complex calcified atheromatosis of the aorta, defined as calcified plaques measuring > 4mm in size, ulcerated or having a mobile component are potentially emerging sources of cardioembolic infarction. We present a case of severe cardioembolism with evidence of complicated calcified aortic plaques in an otherwise healthy78 year old female.

complex aortic plaques embolic infarcts ischemic infarction

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Arboix A, Alioc J. Cardioembolic stroke: clinical features, specific cardiac disorders and prognosis. Current cardiology reviews. 2010 Aug 1; 6(3): 150-61.
[2]  Bogousslavsky J, Bernasconi A, Kumral E. Acute multiple infarction involving the anterior circulation. Archives of neurology. 1996 Jan 1; 53(1): 50-7.
[3]  Agmon Y, Khandheria BK, Meissner I, et al. Relation of coronary artery disease and cerebrovascular disease with atherosclerosis of the thoracic aorta in the general population. Am J Cardiol. 2002; 89: 262-7.
[4]  Amarenco P, Duyckaerts C, Tzourio C, Henin D, Bousser MG, Hauw JJ. The prevalence of ulcerated plaques in the aortic arch in patients with stroke. N Engl J Med. 1992; 326: 21-5.
[5]  The French Study of Aortic Plaques in Stroke Group. Atherosclerotic disease of the aortic arch as a risk factor for recurrent ischemic stroke. N Engl J Med. 1996; 334: 1216-21.
[6]  Ferrari E, Vidal R, Chevallier T, Baudouy M. Atherosclerosis of the thoracic aorta and aortic debris as a marker of poor prognosis: benefit of oral anticoagulants. J Am Coll Cardiol. 1999; 33: 1317-22
[7]  Katsanos AH, Patsouras D, Tsivgoulis G, Kosmidou M, Katsanos KH, Kyritsis AP, Giannopoulos S. The value of transesophageal echocardiography in the investigation and management of cryptogenic cerebral ischemia: a single-center experience. Neurological Sciences. 2016 Apr 1; 37(4): 629-32.
[8]  Zaidat OO, Suarez JI, Hedrick D, et al. Reproducibility of transesophageal echocardiography in evaluating aortic atheroma in stroke patients. Echocardiography. 2005; 22: 326-30.
[9]  Altieri M, Metz RJ, Müller C, Maeder P, Meuli R, Bogousslavsky J. Multiple brain infarcts: clinical and neuroimaging patterns using diffusion-weighted magnetic resonance. European neurology. 1999 Aug 26; 42(2): 76-82.
[10]  Tenenbaum A, Fisman EZ, Schneiderman J, et al. Disrupted mobile aortic plaques are a major risk factor for systemic embolism in the elderly. Cardiology. 1998; 89: 246-51.
[11]  Antiplatelet trialists’ collaboration. Collaborative overview of randomized trials of antiplatelet therapy. Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ. 1994; 308: 81-106.
[12]  Bhatt DL, Fox KAA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med. 2006; 354: 1706-17.
[13]  Hausmann D, Gulba D, Bargheer K, Niedermeyer J, Comess KA, Daniel WG. Successful thrombolysis of an aortic-arch thrombus in a patient after mesenteric embolism. N Engl J Med 1992; 327: 500-501.