The Simultaneous Occurrence of Acute ST-Elevation Myocardial Infarction, Acute Ischemic Stroke, and Pulmonary
Homayoon Lodeen1, Saliman Esmati2, Tetyana Okan1
1Internal Medicine, Jamaica Hospital Medical Center, New York, USA.
Insights
A rare case of a 70-year-old woman experienced simultaneous acute myocardial infarction, ischemic stroke, and pulmonary embolism. Despite treatment, she developed brain death, highlighting the severe prognosis of this triad.
Area of Science:
- Cardiology
- Neurology
- Pulmonology
Background:
- Acute ST-elevation myocardial infarction (STEMI), acute ischemic stroke (AIS), and acute pulmonary embolism (PE) are critical emergencies with high mortality rates.
- The simultaneous occurrence of these three conditions presents a complex and severe clinical challenge.
Observation:
- A 70-year-old woman presented with a rare triad of acute STEMI, AIS, and PE.
- Risk factors included atherosclerotic heart disease, atrial fibrillation, and a prolonged flight.
Findings:
- Diagnoses were confirmed via emergent coronary/cerebral angiography and CT pulmonary angiogram.
- The patient received medical therapy and endovascular thrombectomy.
- Complications included subarachnoid hemorrhage, leading to brain death.
Implications:
- This case underscores the grave prognosis associated with the STEMI, AIS, and PE triad.
- It highlights the critical need for rapid diagnosis and multidisciplinary management in such complex cases.
- Further research may explore optimal treatment strategies for this rare clinical presentation.
Abstract:
Acute ST-elevation myocardial infarction (STEMI), acute ischemic stroke (AIS), and acute pulmonary embolism (PE) are life-threatening conditions, each posing a high risk of morbidity and mortality. When all three of these acute conditions occur simultaneously, the overall prognosis for the patient becomes considerably worse. We report a case of a 70-year-old woman who presented to the emergency department (ED) with a triad of acute STEMI, AIS, and PE as a consequence of atherosclerotic heart disease, atrial fibrillation, and a prolonged transatlantic flight. The diagnoses were promptly confirmed through emergent coronary and cerebral angiography, along with a computerized tomography pulmonary angiogram (CTPA). The patient underwent a combination of medical therapy and endovascular thrombectomy. However, she later developed a subarachnoid hemorrhage and eventually progressed to brain death.
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