Carotid Endarterectomy in a Patient With Type 2 Myocardial Infarction During Preparation for Surgery: A Case Report

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Giora Landesberg1, Ronza Salem2, Eyal Avraham2

  • 1From the Departments of Anesthesiology, Critical Care and Pain Medicine.

A&A Practice
|April 16, 2019
PubMed

Insights

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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