D here are encountered during common clinical practice, in which the diagnosis cannot definitively be proven but is the most likely possibility. In the present case, the diagnosis was achieved via systematic use of imaging procedures and reconsideration of blood tests that explored thrombosis. This allowed a deeper and more detailed analysis of the case beyond the conventional approach that would have aimed to identify one cause for the condition at hand, in this case, atrial fibrillation. This broaderIuliano et al. Journal of Medical Case Reports 2011, 5:186 http://www.jmedicalcasereports.com/content/5/1/Page 5 ofapproach resulted in the diagnosis of multiple embolisms from multiple sites and as a result of multiple causes.6.Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.Abbreviations JAK2: Janus kinase 2; PDB: patent ductus botalli. Author details 1 Department of Medical Sciences and Biotechnology, Vascular Medicine and Atherothrombosis Laboratory, Sapienza University of Rome, corso della Repubblica 79, IT-04100 Latina, Italy. 2Unit of Vascular Medicine, Goretti Hospital, via Guido Reni 3, IT-04100 Latina, Italy. 3Unit of Vascular Surgery, Goretti Hospital, via Guido Reni 3, IT-04100 Latina, Italy. 4Unit of Cardiology, Goretti Hospital, via Guido Reni PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/13485127 3, IT-04100 Latina, Italy. 5Department of Cellular Biotechnology and Hematology, Sapienza University of Rome, via Benevento 6, IT-00161 1-(5-(Aminomethyl)-2-nitrophenyl)ethanol Rome, Italy. Authors' contributions LI interpreted the patient data regarding the multiple thrombosis and was a major contributor to the writing of the manuscript. MMis and AP collected the clinical data and reviewed the literature. MMis, AV, MMas, and GB were in charge of patient management for the surgical procedures. MR obtained and interpreted the echocardiographic studies. GC conducted JAK2 mutation analysis. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Received: 24 August 2010 Accepted: 14 May 2011 Published: 14 May 2011 References 1. Laperche T, Laurian C, Roudaut R, Steg PG: Mobile thromboses of the aortic arch without aortic debris: a transesophageal echocardiographic finding associated with unexplained arterial embolism. The Filiale Echocardiographie de la Soci ?Fran ise de Cardiologie. Circulation 1997, 96:288-294. 2. Wolf PA, Abbott RD, Kannel WB: Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991, 22:983-988. 3. Cabin HS, Clubb KS, Hall C, Perlmutter RA, Feinstein AR: Risk for systemic embolization of atrial fibrillation without mitral stenosis. Am J Cardiol 1990, 65:1112-1116. 4. Fuster V, Ryd LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN2-(4-Carbamoylpiperidin-1-yl)acetic acid hydrochloride2-(4-Carbamoylpiperidin-1-yl)acetic acid hydrochloride Abstract(s)">PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/12113769 R, Ornato JP, Page RL, Riegel B, Priori SG, Blanc JJ, Budaj A, Camm AJ, Dean V, Deckers JW, Despres C, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Tamargo JL, Zamorano JL, American College of Cardiology; American Heart Association Task Force; European Society of Cardiology Committee for Practice Guidelines; European Heart Rhythm Association; Heart Rhythm Society: ACC/AHA/ESC 2006 guidelines for the m.