CASE PRESENTATION: A 62-year old woman was hospitalized because of intermittent cough and dyspnea for 8 months, aggravating with fever for 4 days. The symptoms relieved intermittently by anti-infection treatment. On presentation, her admission temperature was 38.1℃ and D-dimer level was 5.86ug/ml. Chest CT scan revealed a multiple patched and nodal image with hilus pulmonis and mediastina lymph nodes enlargement, part of which had been calcified (Figs 1A-C). The patient received standard 4-drug antituberculous therapy and anti-infection treatment. On hospital day 13, dyspnea aggravated with heart palpitation. Electrocardiogram has shown atrial flutter (Fig 2A). After cedilanid 0.2mg by intravenous injection, atrial flutter changed to sinus rhythm (Fig 2B). On hospital day 16, a sudden epigastric pain occurred. Echocardiography and enhancement CT confirmed left ventricular thrombus and splenic infarction (Figs 1D, 2C). After 3-day-treatment of low molecular heparin and warfarin, when INR rose from 1.46 to 2.81, molecular heparin was discontinued. Antituberculous therapy was going on. On hospital day 28, her fever dropped to normal and her left ventricle thrombosis disappeared (Fig 2D). Results of CT-guided percutaneous needle lung biopsy confirmed tuberculosis (Figs 2E, 2F).