Thrombophilia: An Amalgam of Never Ending Clinical Manifestations

Thrombophilia is a blood coagulation disorder, in which blood has an increased tendency to clot, with both arterial and venous localization, being responsible for multiple manifestations: secondary arterial hypertension, stroke, acute pancreatitis or intracardiac masses. We are presenting the case of a 21-year-old male patient, hypertensive, known with thrombophilia, who was sent for the echocardiographic evaluation of an intracardiac mass attached to the posterior leaflet of the mitral valve. The echocardiography and transesophageal echocardiogram showed a hyperechogenic, homogeneous intracardiac mass, attached to the posterior leaflet of the mitral valve, the clinical context and the echocardiographic appearance being suggestive for a thrombus. Given the context of thrombophilia and the hypertension’s characteristics, we considered a secondary form of hypertension, the incriminated mechanism being represented by microthrombosis in the renal arterial circulation. There were two complications in the evolution of the patient: stroke and the recurrent acute pancreatitis, both being explained in the context of thrombophilia. The discharge echocardiography showed a favorable evolution, with a complete resolution of the thrombus under the anticoagulant treatment.