INTRODUCTION
Intracardiac masses are usually detected incidentally during
echocardiography or in the setting of a systematic approach to a
patient’s symptoms. The most common entities are thrombi, vegetation,
and to a lesser extent, cardiac tumors1; nonetheless,
on the rare occasion of the presence of multiple intracardiac masses,
all of them should be considered in the differential
diagnosis.2, 3 Intracardiac thrombosis (ICT) is
commonly detected in the presence of a predisposing factor; in some
instances, however, it implies a potentially underlying serious
condition, the most notable instance of which is the possibility of
systemic inflammatory diseases in the presence of right heart
thrombi.3, 4 Antiphospholipid syndrome (APS) is a
heterogeneous autoimmune disease that is characterized by vascular
thrombosis, complicated pregnancy, and elevated antiphospholipid
antibodies. Although valvular disease is the most common presentation of
APS, ICT may be the main clinical manifestation of this systemic
inflammatory disease.5 We herein describe a young man
with a diagnosis of APS who presented with fever and multiple
intracardiac masses. Besides highlighting this rare presentation, we
underscore the diagnostic and therapeutic value of inflammatory
thrombosis.