[Giant intracavitary thrombi secondary to a heparin-induced thrombocytopenia-thrombosis syndrome]

The secondary thrombocytopenia to heparin is not infrequently seen; nevertheless, the heparin-induced thrombocytopenia-thrombosis is much less frequent and associated to high mortality. We show one heparin induced thrombocytopenia-thrombosis syndrome with developed thrombi in the cardiac cavities. Its physiopathologic mechanism was reviewed, the importance of clinic suspicion in the presence of: thrombi in a rather unusual place, thrombi resistant to the common anticoagulant therapy, thrombosis repetition or thrombosis in a person with anticoagulant therapy by heparin. The complexity of its treatment, as well as the transesophageal echocardiography utility in diagnostics of thrombus on cardiac cavities, and its relationship with the reaction to the treatment, is discussed.