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Carotid Endarterectomy in a Patient With Type 2 Myocardial Infarction During Preparation for Surgery: A Case Report
Giora Landesberg1, Ronza Salem2, Eyal Avraham2
1From the Departments of Anesthesiology, Critical Care and Pain Medicine.
A&A Practice
|April 16, 2019
Summary
A patient with carotid stenosis developed type 2 myocardial infarction before surgery. The case highlights the complex decisions regarding proceeding with carotid endarterectomy versus postponing surgery after myocardial infarction.
Area of Science:
- Cardiology
- Vascular Surgery
- Nephrology
Background:
- Patient presented with severe carotid stenosis and amaurosis fugax, necessitating carotid endarterectomy.
- Significant comorbidities included coronary artery disease, hypertension, chronic renal failure, and anemia.
Observation:
- During preoperative assessment for carotid endarterectomy, the patient experienced symptoms suggestive of type 2 myocardial infarction.
- Electrocardiogram showed ST depressions and laboratory tests revealed elevated troponin levels.
Findings:
- The development of type 2 myocardial infarction presented a critical clinical dilemma regarding surgical intervention.
- Diagnostic workup and decision-making processes for managing this complex preoperative scenario are detailed.
Implications:
- This case underscores the challenges in managing patients with critical vascular disease and acute cardiac events.
- Optimal timing for carotid endarterectomy in the setting of perioperative myocardial infarction requires careful consideration of individual risk factors.
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