ST-elevation myocardial infarction associated with acute ischemic stroke

Randomized clinical studies have demonstrated that tissue plasminogen activator thrombolytic therapy improves functional outcomes. Recently the time window for tissue plasminogen activator thrombolytic therapy has been extended from 3 to 4.5 h after ischemic stroke onset, which will allow more ischemic stroke patients to benefit from this treatment. Healthcare providers should also ascertain whether the ST-elevation myocardial infarction (STEMI) patient has also neurological contraindications to fibrinolytic therapy, including any history of intracranial hemorrhage, significant closed head or facial trauma within the past 3 months, uncontrolled hypertension, or ischemic stroke within the past 3 months (EXCEPT acute ischemic stroke within 3 h). History of prior ischemic stroke greater than 3 months is a relative contraindication. We present a case of tissue plasminogen activator thrombolytic therapy in a 68-year-old Italian man admitted to the Emergency Department with heart failure, ischemic stroke and ST-elevation myocardial infarction. Also this case focuses attention on regression of ischemic stroke symptoms in STEMI patient treated with tissue plasminogen activator thrombolytic therapy.