Thrombus of the ascending aorta as a source of cerebral embolism

A 74-year-old woman presented with a stroke. Transesophageal echocardiography showed evidence of a thrombus attached to the wall of the ascending aorta that was not detected by the transthoracic approach. The thrombus was no longer present after treatment with heparin with no recurrent embolic event. To our knowledge, this is the first report of a thrombus attached to the ascending aorta that was no longer present after treatment with heparin, was detected by transesophageal echocardiography, and was thought to be the source of cerebral embolic event.