A rare case of free floating thrombus in the aorta and left ventricle – a case report

Objective: Aortic thrombi, though rare, represents a significant medical entity requiring precise diagnosis and management. We describe an intriguing case of cardiac syncope resulting from an free-floating thrombus in the aorta. Case presentation: A 27-year old male smoker presented with recurrent episodes of syncope. Diagnostic investigations (echocardiography, computed tomography, magnetic resonance imaging) unveiled the presence of thrombi within the ascending aorta and the left ventricle. The patient underwent successful surgical removal of free-floating thrombus in aorta and left ventricle. The proper anticoagulation was initiated before and continued after surgery along with antiaggregant therapy to prevent embolization and recurrence. Conclusion: Given the lack of extensive data, the management of aortic thrombosis remains variable, encompassing strategies ranging from anticoagulant pharmacotherapy to surgical intervention, or a combination of both. The absence of established guidelines further underscores the intricacies in the therapeutic approach to this condition. We delineate the clinical trajectory of the patient who underwent successful surgical excision of the thrombus considering the risk of cerebral and distant embolic phenomenon, which may be life threatening,