Asymptomatic intracardiac thrombi and primary antiphospholipid syndrome

Intracardiac thrombi have rarely been reported in patients with the antipho spholipid syndrome. We describe a new case revealed by systematic echocardi ography in an asymptomatic woman who consulted for mild thrombocytopenia. O ur case is characterized by a past history of migraine, fetal loss and psyc hiatric disturbances and by a high level of antiphospholipid antibodies (an ticardiolipin, anti-beta 2-glycoprotein I and lupus anticoagulant). Echogra phy, in the absence of a ny cardiovascular symptom, showed bulky right intr a-atrial thrombi requiring surgical excision. Histopathological analysis re vealed the fibrino-cruoric nature of the lesion without myxoma. This case s hows that, when faced with a mild thrombocytopenia associated with antiphos pholipid antibodies, echocardiography may reveal a life-threatening and com pletely asymptomatic intracardiac thrombosis. Copyright (C) 2000 S. Karger AG, Basel.