An aortic thrombosis is a blood clot that forms in the aorta, the primary artery leading away from the heart. It is rare but is a medical emergency.

An aortic thrombosis can disrupt the seamless flow of blood, impeding the circulation of oxygen-rich blood to vital organs and tissues. As a result, there can be potentially life threatening consequences.

A person with an aortic thrombosis requires emergency medical care. Doctors may use medications to break apart the blood clot or recommend surgery to remove it.

This article examines aortic thrombosis, including its causes, symptoms, and treatment.

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Aortic thrombosis may have various symptoms, or an individual may remain asymptomatic — meaning they have no symptoms — until the condition advances or complications arise.

However, common symptoms associated with aortic thrombosis include:

Prompt recognition of these symptoms is crucial, as aortic thrombosis can swiftly escalate.

Certain risk factors increase the likelihood of developing a blood clot in the aorta. Named after Dr. Rudolf Virchow, the Virchow triad comprises:

  • injury to the blood vessel wall from catheterization or another cause
  • thick blood that sticks together easily
  • changes in blood flow due to extended periods of immobility or other causes

Aortic thromboses can develop in people with heart catheters, a hollow tube fed into the heart through the blood vessels. While the catheter can help diagnose or treat certain heart conditions, it can also inflame the blood vessel walls. This then increases blood clot risk.

Aortic thrombus is rare in healthy individuals, but other potential risk factors include:

The medical literature, specifically four case reports, also notes aortic thrombosis as a rare complication of COVID-19.

Diagnosing aortic thrombosis requires a comprehensive evaluation that combines clinical assessment, imaging techniques, and diagnostic tests.

Doctors typically ask additional questions after reviewing a person’s family and personal history, and this can include questions regarding:

  • birth control because some birth control medications can increase the risk of blood clots
  • recent activities, such as whether the person has been on a recent long trip — long trips or car rides can cause the person to be inactive for a while and increase the risk of blood clots
  • recent surgery, which can also lead to inactivity and increase the risk of blood clots
  • other factors

Learn more about risk factors for blood clots.

Imaging techniques that doctors often rely on include results from the following:

Blood tests, including D-dimer assays and coagulation profiles, can aid in assessing clotting tendencies and ruling out other potential causes of symptoms.

Blood tests

D-dimer is a fibrin degradation product present in the blood. It serves as a marker of ongoing fibrinolysis, the process of breaking down clots. D-dimer assays measure the concentration of D-dimer in the blood, which can help in deciding if there is a clot. If the D-dimer levels are elevated, the next step would be ordering imaging tests to determine where the clot is.

Coagulation profiles evaluate the blood’s ability to clot and the various factors involved in the coagulation cascade. They include prothrombin time (PT) and activated partial thromboplastin time (aPTT). Abnormalities in coagulation profiles can indicate disruptions in the intricate balance of blood clotting, which may suggest underlying coagulation disorders.

Doctors treat aortic thrombosis with medications to break up the clot or with surgery to remove it.

A medication called heparin is given in a hospital setting, as it is given intravenously (IV) or as an intramuscular injection. Once the clot is controlled, the patient can use Warfarin or direct oral anticoagulants (DOACs), such as apixaban or rivaroxaban, to manage their condition in the longer term.

In a 2022 literature review, the authors noted that doctors treated 50% of people involved in this review with aortic thromboses with medications, 34% with minimally invasive endovascular procedures, and 16% with traditional surgery.


Surgery is most likely recommended if the clot is larger than 1 centimeter across and the individual has a history of blood clots.

Doctors may also choose surgery if the clot develops in certain parts of the aorta or if it is impossible to distinguish the blood clot from a mass using imaging tests.

However, surgical intervention is often the second treatment choice after other treatments have been unsuccessful. If the person shows signs of being hemodynamically unstable — for example, they have low blood pressure — then urgent surgery may be necessary and is prioritized over other treatments.

Prompt medical attention is important when a person has symptoms of aortic thrombosis.

Given the potential for rapid progression and severe complications, it is important that individuals experiencing sudden and intense abdominal or back pain — particularly if it radiates to the chest or limbs — or any other aortic thrombosis symptoms, get immediate medical help.

Swift evaluation by healthcare professionals is critical to diagnose and treat the issue immediately.

An aortic thrombosis can cause potentially life threatening complications.

Because it is a rare occurrence, there is little available information on a person’s outlook when receiving a diagnosis. However, experts believe they can be fatal in about 75% of cases.

When a clot blocks blood flow through the aorta, every single organ downstream of the blockage will experience ischemia or lack of blood flow. The extent of damage depends on the extent of the blockage and the specific organs affected depend upon the location of the blockage.

If a person does not receive swift treatment, they can develop severe complications.

COVID-19 and aortic thrombosis

In a series of four case studies involving individuals with COVID-19 and aortic thrombosis, there were:

  • two cases of stroke
  • one case of pulmonary embolism, or blood clot in an artery in the lungs
  • two cases of acute limb ischemia, which is a loss of blood flow to a limb
  • one case of acute mesenteric ischemia, which is a loss of blood flow to the intestines
  • one case of deep vein thrombosis (DVT)

COVID is known to cause hypercoagulability and clots. The relationship between the conditions is complex.

Some of these complications are not COVID-specific, meaning they can potentially be seen in any aortic thrombosis diagnoses.

Aortic thrombosis is a blood clot that forms in the body’s largest artery, the aorta. It can restrict or stop vital blood flow to organs, leading to serious consequences. However, it is extremely rare.

Doctors use imaging studies to diagnose aortic thrombosis. They treat it with medications to break the clot apart or with surgical removal.

Anyone experiencing intense abdominal or back pain and cold extremities should get emergency medical attention. Aortic thrombosis is a condition where swift intervention can greatly impact a person’s outcome.