Ischemic stroke is the most common neurological complication of endocarditis. Approximately 20% of patients with infective endocarditis (IE) present with stroke and in more than a third of them with nonbacterial thrombotic endocarditis (NBTE). Stroke is often one of the first symptoms of endocarditis. Population-based studies on cryptogenic stroke as defined by TOAST is 25% [1]. Not only the acquired risk factors are significant in vascular incidents, but also the genetic. The predisposition to thrombosis may be a result of genetic factors, acquired changes in the clotting mechanism or interaction between them. Impaired fibrinolytic function secondary to elevated plasminogen activator inhibitor-1 (PAI-1) levels has been implicated in ischemic stroke. We present a clinical case of a 33 year old female with several ischemic strokes with unknown cause.