Acute coronary syndromes associated with thrombus in the sinus of valsalva and normal coronary arteriography: the pivotal role of transesophageal echocardiography in the intensive care unit.

We describe 4 patients with thrombus in nonaneurysmal sinus of Valsalva. The diagnosis was made with transesophageal echocardiography performed in the Intensive care unit, in the setting of acute coronary syndromes. Coronary arterlography showed normal coronary arteries in each patient. In 3 patients, conservative medical therapy resulted in full recovery. Two patients had previously undergone aortic valve surgery.