High prevalence of pulmonary vein thrombi in elderly patients with chest pain, which has relationships with aging associated diseases

Aim

Pulmonary vein thrombi (PVT) are believed to be rare. Some cases of PVT were reported in patients with lung cancer, thoracic surgery or catheter ablation. PVT are a possible cause of systemic embolism, but little is known about its complications. Since 2012, we have reported seven cases of PVT in patients without these predisposing factors.

The aim of the present study was to clarify whether PVT were rare or not in patients without these predisposing factors and how can we treat patients with PVT.

Methods

We performed 64-slice multidetector CT (64-MDCT) scans on 57 consecutive Japanese patients (28 men and 29 women; age = 73.8 ± 8.6 years old) with chest pain, but they didn't have lung cancer, thoracic surgery or catheter ablation, from September 2012 to March 2013.

Results

Coronary artery plaque was detected in 32 patients (56%). PVT were clearly demonstrated in 35 patients (61%), which indicated that PVT are not rare. Furthermore, 32 patients (91%) among 35 patients with PVT had no cerebral infarctions. In older people, PVT are not uncommon and have many clinico-pathologic correlations. Small or fine thrombi in the pulmonary vein should occlude a small artery of every organ and make effects on many diseases, which are not recognized by almost all medical doctors.

Conclusions

PVT are common observation in patients with chest pain and no clear predisposing factor. Further studies are required to assess if PVT can be considered as an etiology of chest pain and to determine its optimal management.