Traumatic Brain Injury With Concomitant Myocardial Infarction: A Clinical Dilemma

A 51-year-old male patient was brought to the emergency department (ED) by paramedics after an unwitnessed fall from a height while he was working. He sustained a severe head injury with a low Glasgow Coma Scale (GCS). After securing his airway and stabilizing the patient, a CT scan of the brain was done that revealed bilateral subdural hematomas, and an electrocardiogram (EKG) revealed an ST elevation inferior wall myocardial infarction (MI), which was suggested to be the cause of his fall. With the presence of two concomitant life-threatening medical conditions, it was a predicament which of the two pathologies to target first in treatment. Ultimately, a management plan was decided following a multidisciplinary urgent meeting in the ED, which was attended by all respective teams. Initial conservative management with close neurological and cardiovascular monitoring in the intensive care unit (ICU) was deemed the safest option in this case.