# Thrombotic Storm: A Case of Multiple Concurrent Thrombosis Secondary to Cocaine Use

## TL;DR

A 49-year-old woman developed multiple blood clots after a large cocaine use, leading to serious complications in her heart and abdomen.

## Contribution

This case highlights the rare but severe concurrent thrombosis associated with cocaine use.

## Key findings

- Cocaine use led to left ventricular mural thrombus and mesenteric artery ischemia.
- The patient also had renal and splenic infarcts.
- Anticoagulation treatment caused retroperitoneal hematoma.

## Abstract

Cocaine abuse is known to have deleterious effects on multiple organ systems. Its effects on the cardiovascular system are well-established in the literature. The presence of a left ventricular thrombus (LVT) is a well-recognized complication of an anterior myocardial infarction, especially in patients with aneurysmal formation. There is a paucity of reports where cocaine use and LVT are associated with myocardial infarction and mesenteric ischemia simultaneously. Our patient is a 49-year-old female, who presented to our institution after ingesting a large volume of cocaine. She complained of abdominal pain, chest pain, and was eventually found to have a left ventricular mural thrombus with concomitant superior mesenteric artery ischemia, and renal and splenic infarcts. Administration of therapeutic anticoagulation resulted in the development of retroperitoneal hematoma resulting in a therapeutic dilemma.