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Echocardiographic demonstration of right ventricular thrombosis is relatively common in pulmonary embolism. There are also reports of right ventricular thrombi in patients affected by right myocardial infarction or dilated cardiomyopathy. In arrhythmogenic right ventricular cardiomyopathy single or multiple aneurysms are often present in the right ventricular free wall. These hypoakinetic areas represent a site for potential development of thrombi especially in advanced disease states. In the literature a single case of a patient affected by arrhythmogenic right ventricular cardiomyopathy with right heart failure and atrial and ventricular thrombi is reported. We report a case of arrhythmogenic right ventricular cardiomyopathy with a right ventricular thrombus located inside a single apical aneurysm in the presence of normal right ventricular systolic function.

A clinical case of syndrome of antiphospholipid antibodies is reported. The patient is a 10-year-old girl with thrombophlebitis of the right leg associated with the presence of lupus-like anticoagulant antibodies. No secondary pathologies were found. It is not possible, anyway, to make a definitive differential diagnosis between primary and secondary forms of syndrome of antiphospholipid antibodies because of intermediate situations where antiphospholipid antibodies are associated with 2 or 3 ARA criteria for the diagnosis of lupus (lupus-like syndrome). A long term follow-up is therefore necessary.

In our hospital, 199 patients following oral anticoagulant therapy were studied and controlled. They were divided into two groups according to the follow-up period. The first group was treated for 24-40 weeks. The second group was treated for 6-24 weeks. In the first group, 169 (98.3%) of the 172 patients studied maintained therapeutic range INR (2.1-4.8) for a period of 70%-100% of the total observation time, whereas 3 patients (1.7%) did not have a valid therapeutic response. The percentage of subjects within therapeutic range in the second group of 27 patients was decidedly inferior. Five of these patients were not able to achieve the desired results, probably because of a too brief period and undertreatment.

Levels of hypocoagulabity induced with coumarin derivatives (aconocoumarin) were determined in 10 patients Quick's test was used to calibrate commercially available thromboplastin reagents against a reference reagent. The results were then standardised in the form of a correct prothrombin ratio. It was found that comparable results could be obtained, even with poorly sensitive thromboplastins, by determining a thromboplastin sensitivity index and using it to convert the prothrombin ratio obtained with each thromboplastin into a "correct" ratio, i.e. one that allowed for the depressed sensitivity of the thromboplastin concerned. It was found that thrombotest was more sensitive than the commercial thromboplastins; it was also superior to the reference reagent in expressing the level of drug-induced hypocoagulability. Attention is drawn to the soundness of expressing prothrombin times in terms of the correct ratio to cut out the effect of variations in sensitivity on the part of commercial thromboplastins. At the same time, stress is laid on the superiority of thrombotest in the monitoring of oral anticoagulant therapy.