The Clot Strikes Thrice: Case Report of a Patient with 3 Concurrent Embolic events.

Purpose: Concurrent cerebral and systemic embolism are unusual occurrences. Acute myocardial infarction secondary to coronary embolism are particularly rare with only isolated reports in the literature.

Case Report: A 49-year old Chinese man presented with right posterior cerebral artery infarction to our hospital. He developed chest pain and ST-elevation on ECG the next morning. Urgent cardiac catheterization showed a right coronary artery as well as a right profunda femoris artery occlusion. The cause of these 3 concurrent emboli was a large mobile left ventricular thrombus seen on echocardiography. Urgent anticoagulation was initiated, and the patient returned home after 1 month of rehabilitation with no further ischemic events.

Conclusion: In selected patients with high embolic risks, urgent anticoagulation after acute ischemic stroke can be a possible treatment option.