Biventricular and Multisystem Thrombosis in a Young Patient With Elevated Factor VIII: A Case Report

TL;DR

A young man with no clear risk factors developed severe blood clots due to high Factor VIII levels, highlighting the need for early diagnosis and targeted treatment.

Contribution

This case report highlights elevated Factor VIII as a rare but critical cause of severe thrombosis in young adults.

Findings

A 26-year-old male presented with extensive thrombosis involving multiple systems and biventricular thrombus.

Elevated Factor VIII was the only identified cause of the prothrombotic state.

Successful treatment involved anticoagulation and antiplatelet therapy with a multidisciplinary approach.

Abstract

Thrombosis in young adults without evident risk factors warrants investigation for underlying hypercoagulable states. We report the case of a 26-year-old male patient with a history of deep vein thrombosis (DVT), who presented with an extensive multisystem thrombotic cascade including acute limb arterial ischemia, bilateral pulmonary embolism, and bilateral renal vein thrombosis. Cardiac imaging revealed apical akinesis and a large biventricular thrombus with an ejection fraction of 41%. A comprehensive workup for thrombophilia identified a markedly elevated Factor VIII (FVIII) level as the only positive finding. This case underscores that high FVIII can drive a severe prothrombotic phenotype, leading to rare and devastating complications like biventricular thrombosis. The successful management with a multidisciplinary approach involving anticoagulation and antiplatelet therapy highlights the critical importance of early diagnosis to guide targeted therapy and prevent life-threatening recurrence.

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