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.