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A Rare Coexistence of Simultaneous Cardio-Cerebral Infarction
Vijay Yadav1, Ratna Mani Gajurel1, Chandra Mani Poudel1
1Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Kathmandu, Nepal.
Insights
Cardio-cerebral infarction (CCI), concurrent acute myocardial infarction (AMI) and acute ischemic stroke (AIS), requires individualized emergency treatment. This case highlights successful simultaneous mechanical thrombectomy and percutaneous coronary intervention.
Area of Science:
- Cardiology
- Neurology
- Interventional Medicine
Background:
- Cardio-cerebral infarction (CCI) involves simultaneous acute myocardial infarction (AMI) and acute ischemic stroke (AIS), presenting a rare and complex medical emergency.
- Effective management is challenging due to the need to prioritize interventions, where treating one condition may delay critical care for the other.
Background:
Contemporaneous acute myocardial infarction (AMI) and acute ischemic stroke (AIS), termed cardio-cerebral infarction (CCI), is a rare medical emergency. The effectual management of this situation is exigent since early management of one condition will inevitably delay the other. Case Presentation. A 60-year-old woman presented to our hospital with concurrent AMI of the inferior left ventricular wall, complicated by cardiogenic shock and transient complete heart block, and AIS of more than 4.5 hour duration. The cerebral computerized tomography angiography revealed a right-sided terminal internal carotid artery (ICA) occlusion, and the coronary angiogram depicted double vessel disease with a culprit lesion in the right coronary artery (RCA). The patient underwent mechanical thrombectomy for the ICA occlusion by an interventional neuroradiologist followed by the primary percutaneous coronary intervention of the culprit RCA by the interventional cardiologists in the same setting.
Conclusion:
A patient with concurrent AMI and AIS is a challenging situation to treat in the emergency department, and the treatment must be individualized for each patient.
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