Left atrial myxoma presenting as acute limb ischemia of 3 limbs with saddle embolus of abdominal aorta bifurcation and intra cranial bleed -- a rare phenomenone

Left atrial myxoma is the most common variant of cardiac tumour, rarely presenting with systemic embolization involving 3 limbs and intra cranial bleed simultaneously. Our case aims to discuss appropriate management strategy in such cases. This case presents a 34 year old lady with acute limb ischemia both lower limb and right upper limb with intracranial bleed with no signs of congestive heart failure diagnosed with LA Myxoma on preoperative routine 2d ECHO cardiography. She underwent embolectomy of right brachial artery and bilateral femoral artery, common iliac artery and abdominal aorta with excision of LA Myxoma planned for 4 weeks later. In patients presenting with acute limb ischemia and intracranial bleed, the definitive surgery of LA myxoma excision should be postponed for 4 weeks to prevent risk of systemic heparinisation causing worsening of neurological functions while acute limb ischemia should be addressed immediately.