Introduction:
A Patient with Human Immunodeficiency Virus (HIV) has an increased risk of developing coronary artery diseases (CAD) either through traditional CAD risk factors, antiretroviral drug effects or HIV-related parameters including inflammatory and immunologic changes (1). Also an increased risk of stroke either including HIV-related intra- and extra-cranial vasculopathy, HIV induced cardiomyopathy, HIV-induced coagulopathy and opportunistic infection-associated vasculitis; However, this is mostly significant among those younger than 50, but not among older patients (2,3). The most significant early manifestation of HIV infection among Africans was marked by slim disease (diarrhea and wasting), tuberculosis, variety of Opportunistic Infections (OI), weight loss, fever, and dermatological symptoms(4). Here, we report a young Sudanese male patient whom was diagnosed with Extensive ST segment Elevation Myocardial Infarction (STEMI) complicated later with Ischemic Stroke who was found to have a high HIV viral load with exclusion of other possible causes of his underlying condition.