Background: People with patent foramen ovale are prone to develop strokes due to paradoxical embolization. Determination of association of coagulation disorders with patent foramen ovale is important to determine prognosis and avoid thromboembolic complications. Case Report: Our patient is a 25 year old Lebanese man with history of patent foramen ovale diagnosed at age of 1 year. He presented with severe epistaxis, hemoptysis and melena (INR>6). A kidney biopsy done a year ago showed that the patient has IgA nephropathy. Hypercoagulability workup done on this admission revealed that the patient also has factor V Leiden heterozygosity. Consequently, this patient is at an increased risk of thromboembolic events and developed a stroke at seventeen years of age. Conclusion: This case underlines the importance of special management of patients with patent foramen ovale along with multiple comorbidities resulting in a hypercoagulable state such as IgA nephropathy and factor V Leiden heterozygosity. Hence, further future studies should be conducted to identify the optimal management of these patients.