At day −20, the 59-year-old female patient had an ST-segment elevation myocardial infarction and cardiac arrest. She required cardiopulmonary resuscitation during which a bolus of unfractionated heparin was given, followed by placement of 3 drug-eluting stents in the right coronary artery. Resuscitation was complicated by liver laceration requiring surgery. No thrombosis prophylaxis was given because of the anticipated risk of bleeding after liver injury. Therapeutic-dose low molecular weight heparin was started at day 0 upon diagnosis of a deep vein thrombosis (DVT) of the right leg (enoxaparin; 1 mg/kg body weight twice a day subcutaneously). Severe pulmonary embolism (PE) occurred at day 6, and the platelet count had decreased to 114 per microliter. Anticoagulation was switched to dalteparin (5000 aFXaU twice a day subcutaneously). Three days later, the patient was transferred to the hospital of 1 of the authors (C.P.) with a further myocardial infarction (MI) due to in-stent thrombosis of the right coronary artery. Heparin-induced thrombocytopenia was suspected; the 4T score was 7. All heparins were stopped, and anticoagulation was switched to argatroban. In addition, abciximab and clopidogrel were given. The patient was discharged at day 25 and has remained stable. “HIT test” denotes the time point at which a blood sample was taken for HIT diagnosis; test results are shown below the graph. The PF4/heparin EIA was strongly positive (OD 1.73), but the HIPA was negative.