Concurrent Management of Acute Ischemic Stroke and Myocardial Infarction: A Case Report

Background: Acute myocardial infarction (AMI) and acute ischemic stroke (AIS) are two leading causes of morbidity and mortality. The simultaneous occurrence of these two events is rare and its management is challenging. Case presentation: We report the case of a 59-year-old postmenopausal woman with a history of heavy smoking who presented with sudden-onset right hemiplegia. She was diagnosed with an acute ischemic stroke. Although she did not experience chest pain, the initial electrocardiogram revealed an acute simultaneous ST-elevation myocardial infarction (STEMI). Cerebral computed tomography angiography ruled out aortic dissection and cerebral hemorrhage. The patient was treated invasively for the STEMI by a left anterior descending angioplasty and anticoagulants were stopped immediately after angioplasty while the patient continued to receive dual antiplatelet therapy. The immediate evolution was favorable. The patients did not have heart failure or rhythm complications and the modified Rankin scale score at discharge was 2. Conclusion: Cardio-cerebral infarction Syndrome is a rare but life-threatening condition that requires individualized management. Further studies are needed to develop standardized guidelines for the optimal treatment.