Antiphospholipid syndrome: a recurrent cardiac thromboembolic insult in spite of optimal anticoagulation.

Antiphospholipid syndrome (APS) is an autoimmune disease, with antiphospholipid antibodies associated with hypercoagulability, vascular thrombosis, and fetal loss.1,2 Cardiac involvement occurs frequently, and is deeply related to hypercoagulability in spite of recommended anticoagulant therapy.3 In this report, we describe the images of a Caucasian 19-year-old male, with a previous history, 4 years earlier, of an acute in situ right chamber thromboembolic episode submitted to a surgical intracardiac thrombectomy. At this time APS was diagnosed with increased levels of lupus anticoagulant and IgM anti-beta(2)-glycoprotein I. All other autoantibodies were negative. He was readmitted in April 2012 with an initial suspicion of endocarditis. Intracardiac and