Recurrent Thrombus In A Young Patient

Recurrent thrombus are very rarely observed in young patients. We present of the case of a 24-year old man, who was admitted to our hospital because of acute myopericarditis. On the second day of hospitalization, thyroid function test showed hyperthyroidism, and an echocardiogram study revealed a left ventricular thrombi(16.5*20.4mm) with normal cardiac function(EF 64%), low molecular heparin were given to anticoagulation therapy. On the day four, arterial embolism in the right lower limb was revealed, and thrombectomy was done immediately. Low molecular heparin, warfarin and urokinase were used after surgery, and the pathology showed combined thrombus. He was admitted to hospital again because of myocardial infarction on the 27th day, and coronary angiogram showed plenty of thrombus in left anterior descending branch, percutaneous aspiration thrombectomy was immediately done, aspirin, low molecular heparin, warfarin, metoprolol and thyiamazole were given after surgery. There was no systematic embolism event in the 6 months follow-up. The present case suggests that hyperthyroidism and acute myocarditis could cause a hypercoagulative state.