A case report of acute simultaneous cardiocerebral infarction: possible pathophysiology

Abstract

The occurrence of acute myocardial infarction (AMI) accompanied by ischemic cerebrovascular accidents has rarely been reported in previous articles. In this report, we present a 72-year-old female patient with massive cerebral infarction secondary to acute anterior and high lateral wall myocardial infarction, finally resulting in a deep coma. The patient ultimately failed to respond to aggressive resuscitation and succumbed to cardiogenic shock and fatal ventricular arrhythmias. We consider that the co-occurrence of these diseases is more than just a coincidence, and that there may be a connection between them. In this article, we performed an in-depth exploration and discussion of the explanation of this phenomenon. It is essential to recognize these situations in the early stages, which determines the follow-up treatment and prognosis. We suggest that decisions regarding patient management should be based on hemodynamic stability, close cardiac monitoring, and the site of cerebral infarction, and also emphasize that the evaluation of hemodynamic status in these patients is a prerequisite for deciding whether to treat the cerebral or coronary infarction first. The present report is written for the purpose of reminding readers of this rare and severe situation, and to emphasize the necessity for further research on how to deal with it best.

Keywords: Case Report; acute ischemic cerebral stroke; acute myocardial infarction (AMI); cardiocerebral infarction; management; prognosis.