TWO ACUTE STEMIS AND TWO ACUTE ISCHEMIC STROKES IN THE SAME PATIENT WITHIN FIVE DAYS - WHAT WENT WRONG?

Abstract

It is not uncommon for patients to suffer from both acute myocardial infarction and acute stroke during the hospitalization. According to some studies, about 12% of the elderly population initially hospitalized for acute ischemic stroke also develop type-1 acute myocardial infarction during the same hospitalization. On the other hand, about 0.9% of patients hospitalized for acute coronary syndrome develop acute stroke during the same hospitalization1. The therapeutic approach to such "overlapping" patients is challenging, especially if we also take into account a high risk of bleeding and/or active bleeding. Therefore, interdisciplinary collaboration between cardiology, neurology and interventional neuroradiology is of key importance. Timely intervention and adequate concomitant drug therapy (primarily antiplatelet and anticoagulant therapy) determine treatment outcomes and long-term results. In our recent clinical work, we treated a patient with a series of acute cardiac and cerebral incidents presenting multiple therapeutic dilemmas, who ultimately had an unfavourable neurological outcome.