Abstract
Concurrent myocardial infarction and acute cerebral infarction is a rare and poorly studied phenomenon that presents a challenge to treat as both conditions are life threatening with narrow therapeutic windows. We present the case of a 70 year old female who presented with symptoms concerning for stroke. However, an electrocardiogram revealed she was also having an acute myocardial infarction. The decision was made to treat the stroke with intravenous tissue plasminogen activator. Unfortunately, the patient ultimately decompensated and died. There are many proposed etiologies of this phenomenon including cardiac thrombi leading to concurrent acute myocardial infarction and cerebral infarction, a primary myocardial infarction leading to a cerebral infarction, and a primary cerebral infarction leading to an acute myocardial infarction. Treatment options include simultaneous mechanical thrombectomy and percutaneous coronary intervention in a cardiac catheterization laboratory, or treating with the intravenous tissue plasminogen activator dose for a cerebral infarction and then potentially also proceeding to percutaneous coronary intervention. Ultimately, the management of this situation will depend on the patient’s specific situation including the type of stroke, the extent of irreversible tissue damage, and the hospital’s available resources. A randomized controlled study is difficult because of the rare occurrence of both presentations and a systematic review of the available literature may provide physicians with better insight as to how to approach a simultaneous acute myocardial infarction and acute cerebral infarction.
Highlights
Cardiovascular and cerebrovascular disease are major causes of death and disability globally
We describe a 70 year old female patient who presented with both an acute myocardial infarction (MI) and acute cerebral infarction
Three processes have been proposed: (1) concurrent Cerebral Infarction (CCI), (2) MI leading to cerebral infarction, and (3) cerebral infarction leading to MI
Summary
Khairy M1, Lu V1, Ranasinghe N2, Ranasinghe L3* 1Fourth-year Medical Student, California Northstate University College of Medicine, 9700 W. Received date: 05 December 2020; Accepted date: 15 January 2021; Published date: 23 January 2021 Asp Biomed Clin Case Rep. 2021 Jan 23;4(1):
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