Echocardiography (RM Lang, Section Editor)

Current Cardiology Reports

, Volume 14, Issue 3, pp 342-349

First online:

Aortic Atherosclerosis and Embolic Events

  • Muhamed SaricAffiliated withLeon H. Charney Division of Cardiology, New York University Langone Medical CenterNoninvasive Cardiology Laboratory, New York University Langone Medical Center Email author 
  • , Itzhak KronzonAffiliated withDepartment of Cardiovascular Medicine, Lenox Hill HospitalLenox Hill Interventional Cardiac and Vascular Services

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Abstract

Aortic plaques are a manifestation of the general process of atherosclerosis in which there is a progressive accumulation of cholesterol and other lipids in the intimal-medial layer of the aorta with secondary inflammation, repetitive fibrous tissue deposition, and eventually luminal surface erosions and appearance of often mobile thrombi protruding into the lumen of the aorta. Aortic plaques may give rise to two types of emboli: thromboemboli and atheroemboli (cholesterol crystal emboli). Thromboemboli are relatively large, tend to occlude medium to large arteries, and cause strokes, transient ischemic attacks, and renal infarcts and other forms of peripheral thromboembolism. Cholesterol crystal emboli are relatively minute, tend to occlude small arteries and arterioles, and may cause the blue toe syndrome, new or worsening renal insufficiency, gut ischemia, etc. Transesophageal echocardiography remains the gold standard for visualization of aortic plaques in the thoracic aorta. There are no proven therapies for aortic embolism per se; general atherosclerosis management strategies are recommended.

Keywords

Atherosclerosis Aorta Thromboembolism Atheroma Plaque Atheroembolism Cholesterol embolization syndrome Transesophageal echocardiography 3D echocardiography Computed tomography Magnetic resonance imaging Stroke Transient ischemic attack