In acute myocardial infarction, mural thrombi occur in approximately 20 per cent of patients who do not receive anticoagulant therapy and about 10 percent of thrombi result in systemic embolization. Threrfore, in acute phase of myocardial infarction, heparinization is considered as essential therapeutic regimen which afterwards acute phase, might have no clinical significance. We experienced a patient with recurrent LV apical thrombi inspite of an sufficient anticoagulation. This patient was treated with primary balloon PTCA and optimal duration of anticoa-gulation with IV heparin was maintained. At predischarge follow-up, TTE revealed huge LV apical thrombi and warfarinization was started. Three episodes of appearance and disappearance of thrombi have been noted and we report this patient as thrombophilia associated with acute myocardial infarction.