Cardiac rupture is a complication of myocardial infarction (MI) with extremely high mortality. Poor prognosis is usually predicted in conservatively treated patients. The treatment for cardiac rupture and thrombosis is in conflict. We reported an MI case of cardiac rupture and cerebral thrombosis using a conservative method. This case indicated that (1) It is noteworthy that patients suffering from the subacute form of rupture may remain haemodynamically stable. This type of patients may benefit from a conservative treatment without anticoagulation or antiplatelet at the onset of cardiac rupture. (2) Thirty days following cardiac rupture, it is safe to use warfarin anticoagulation for cerebral thrombosis treatment. The patient suffered from acute MI, cardiac rupture and subsequently cerebral thrombosis. We treated this patient in a conservative manner and the patient remained alive for 8 years. This case suggested that it may be safe to use warfarin anticoagulation treatment for cerebral thrombosis 30 days following cardiac rupture.