Abstract
Cardiocerebral infarction with sinus node dysfunction: A management conundrum?
Highlights
Acute ischemic stroke (AIS) and acute myocardial infarction (AMI) are both life-threatening medical conditions that carry poor prognosis
Kijpaisalratana et al in their review of 8 cases of simultaneous cardiocerebral infarction found that all the ischemic strokes occurred in large vessel territories and majority of them had ST elevation inferior wall MI [5]
It has been postulated that systemic hypotension due to MI can precipitate cerebral infarction, second, thromboembolism from the heart to cerebral vessels
Summary
Acute ischemic stroke (AIS) and acute myocardial infarction (AMI) are both life-threatening medical conditions that carry poor prognosis. In a study by Chin et al, showed that 12.7 % of AIS patients suffered from AMI within 72 hours of admission [1]. Concurrent AMI and AIS pose a unique challenge for physicians as both conditions have a narrow therapeutic time-window and management of one may result in disability in the other. The dual antiplatelets and anticoagulants used in management of AMI can increase risk of hemorrhagic conversion of acute infarct. Use of a thrombolytic in AIS increases the risk of cardiac wall rupture in the setting of AMI. Due to rarity of the condition, the management of these patients is very challenging and there is no ideal recommendation.
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