Vascular thrombosis is a common clinical feature of both essential thrombocythemia (ET) and heparin-induced thrombocytopenia (HIT). The development of HIT in a patient with ET is rare and underrecognized. We report the case of a 77-year-old woman with preexisting ET. who was admitted with acute coronary syndrome. https://macorners.shop/product-category/birth-flower-name-necklace/