Simultaneous Cardiocerebral Infarction Associated with Postcoital Activity
Carl Pastore1, Michael White2, Michael Henry1
1Department of Emergency Medicine, Valleywise Health, Phoenix, Arizona.
Insights
Cardiocerebral infarction (CCI) is a rare, life-threatening condition involving simultaneous heart attack and stroke. Prompt recognition and tailored treatment are crucial for survival, especially in younger patients.
Area of Science:
- Cardiology
- Neurology
- Emergency Medicine
Background:
- Cardiocerebral infarction (CCI) is a rare, critical condition presenting as simultaneous acute myocardial infarction and ischemic stroke.
- It demands immediate recognition and treatment due to high mortality and lack of standardized protocols.
- Existing treatment algorithms address each event individually, not concurrently.
Observation:
- A case report details a 29-year-old male experiencing simultaneous myocardial infarction and thrombotic stroke post-coital activity.
- The patient presented with chest pain, left-sided weakness, and numbness, subsequently suffering cardiac arrest.
- He underwent successful emergent percutaneous coronary intervention with stent placement and showed good neurological recovery.
Findings:
- This case highlights that CCI can occur in young, otherwise healthy individuals, challenging typical demographic assumptions.
- Management requires careful risk-benefit assessment for simultaneous, time-sensitive conditions.
- Optimal treatment strategies need to prioritize the most immediate life-threatening process.
Implications:
- This case contributes valuable data to the limited literature on CCI.
- It underscores the need for emergency physicians to consider CCI in diverse patient populations, including the young.
- Awareness of CCI can improve diagnostic and therapeutic approaches, potentially enhancing patient outcomes.
Background:
Cardiocerebral infarction (CCI) is a rare and life-threatening presentation of simultaneous acute myocardial infarction and acute ischemic stroke that requires prompt recognition and proper treatment. CCI is time sensitive and carries a high mortality rate. There is no standardized treatment algorithm that addresses both conditions simultaneously.
Case Report:
We present a 29-year-old man with simultaneous myocardial infarction and thrombotic stroke after coital activity. He presented to the Emergency Department with left-sided extremity weakness and numbness and radicular left-sided chest pain. He suffered a cardiac arrest during his evaluation and required emergent percutaneous coronary intervention with stent placement. He was resuscitated successfully and had an uncomplicated clinical course, with improved neurologic recovery prior to discharge. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: CCI is a rare condition that typically occurs in elderly patients with risk factors for cardiovascular disease. Management is challenging due to the time-sensitive nature of diagnosis and treatment of each condition. Treatment is not standardized, unlike individual evidence-based algorithms for thrombotic stroke and acute myocardial infarction. Risks and benefits for each treatment plan should be weighed and therapy should be directed toward the most immediate life-threatening process. This case would add to the literature surrounding this condition and help guide emergency physicians toward the most optimal treatment strategies for this patient population. This case also raises awareness of the existence of this condition and its potential presence in young, otherwise healthy patients.
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