Review on Acute Cardio-Cerebral Infarction: a Case Report

Authors

  • Teddy Arnold Sihite Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjajaran/Dr. Hasan Sadikin General Hospital Bandung https://orcid.org/0000-0002-6259-8429
  • Michi Astuti Rehmenda Mario Sitepu Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjajaran/Dr. Hasan Sadikin General Hospital Bandung
  • Cut Azlina Effendi Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjajaran/Dr. Hasan Sadikin General Hospital Bandung

DOI:

https://doi.org/10.15850/ijihs.v9n2.2178

Keywords:

Acute infarct stroke, acute myocardial infarction, Cardio-cerebral infarction

Abstract

Objective: To describe a case of a Cardio-Cerebral Infarction (CCI) male patient presented with a history of chest pain recognized using electrocardiography, brain computed tomography, and Percutaneous Coronary Intervention (PCI).

Methods: A 69 years old man came with history of chest pain since 13 hours before to the emergency room. Electrocardiography, brain computed tomography, and PCI were performed, leading to the diagnosis of CCI.

Results: The electrocardiography showed ST Elevation in Antero-lateral, atrial fibrillation and left-sided hemipharesis, which occurred on the second day. Brain computed tomography demonstrated acute infarct stroke, while the Percutaneous Coronary Intervention (PCI) showed one vessel disease with severe stenosis in LAD and implanted stent in proximal-mid LAD. Therapy prescribed was providing antiplatelet and anticoagulation.

Discussion: Acute Myocardial Infarction (AMI) and Acute Infarct Stroke (AIS) have a narrow therapeutic time-window and a delayed intervention may results in morbidity and death. Antiplatelet and anticoagulant used in PCI for AMI increase the risk for hemorrhagic, and AIS with thrombolytic increase the risk of cardiac wall rupture in AMI. Direct Oral Anticoagulant (DOAC) treatment should reduce ischaemia and lower bleeding. The optimal time point to start anticoagulant treatment might be between 4-14 days after the onset of stroke. Duration of post-PCI triple therapy should be minimized depending on bleeding and risks of ischemia.

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Published

2021-10-19

Issue

Vol. 9 No. 2 (2021)

Section

Case Report

License

Authors retain copyright and grant International Journal of Integrated Health Sciences right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to freely share and remix the work with an acknowledgement of the work's authorship and initial publication in International Journal of Integrated Health Sciences.