Recognizing and addressing the challenges of concomitant cerebrocardiac infarction

In this article, we comment on the article by Zheng et al. This case report shed light on concomitant cerebrocardiac ischemic (CCI) in a 27-year-old male patient, which is defined as a concurrent acute ischemic stroke (AIS) and acute myocardial infarction event. The patient received urgent systemic thrombolysis at the standard dose for AIS and then planned percutaneous coronary intervention was successfully conducted for ST-segment elevation myocardial infarction treatment. Considering the rarity of the comorbidity, the narrow time window for treatment of both AIS and acute myocardial infarction, as well as the complexity and severity of the condition, there are still no guidelines or consensus that have systematically recommended optimal treatment strategies. The successful treatment of this 27-year-old man suggests that urgent thrombolysis followed by planned percutaneous coronary intervention might be an alternative treatment options in the management of concomitant CCI. However, emergency treatment plans need to be developed according to the specific situation of the patients. A number of factors should be considered when making decision, including the location of occlusion of heart and brain, the hemodynamic instability, the ongoing ischemic symptoms, the presence of contraindications to thrombolysis, and the speed of response of cardiologists or neurointerventionists. Future, further research involving multidisciplinary experts, including neurologist, cardiologist, and specialists in critical care medicine is needed to improve the understanding and management of concomitant CCI.