Neurol. praxi. 2022;23(3):252-256 | DOI: 10.36290/neu.2020.045

Coincidence of ischemic stroke and acute myocardial infarction - two case reports

MUDr. Lubomír Jurák, Ph.D.^{1, 2, 3}, doc. MUDr. Vladimír Beneš, Ph.D. III⁴, MUDr. Jan Dienelt⁵, prof. MUDr. Petr Suchomel, Ph.D.¹

¹ Neurochirurgické oddělení, Krajská nemocnice Liberec, a. s., Liberec

² Neurochirurgická klinika LF UP a FN Olomouc

³ Fakulta zdravotnických studií, Technická univerzita v Liberci

⁴ Neurochirurgická klinika dětí a dospělých 2. LF UK a FN Motol, Praha

⁵ Neurologické oddělení, Krajská nemocnice Liberec, a. s., Liberec

Coincidence of ischemic stroke and acute myocardial infarction is not common, but neither it is rare. We present two case reports of patients admitted to hospital for ischemic stroke who have developed acute myocardial infarction with different final outcomes. A 66-year-old woman was admitted to the hospital for symptoms of stroke in the form of severe monoparesis of left upper limb, central left facial nerve paresis, and dysarthria. There was a gradual improvement in the patient's condition after intravenous thrombolysis was administered. The next day, the patient developed stenocardia, sweating, hypotension, and bradycardia and was diagnosed with an acute anterior wall myocardial infarction. Following percutaneous coronary intervention, the patient's symptoms completely regressed. After a total seven-day hospitalization, the patient was released with a mild residual paresis of two fingers of left upper limb without any heart problems. A 69-year-old man was admitted to hospital for symptoms of stroke in the form of somnolence, left-sided hemiplegia and hemihypesthesia, central paresis of the left facial nerve, paresis of the gaze left, neglect of the left-sided syndrome and severe dysarthria. Following intravenous thrombolysis and mechanical thrombectomy, the patient gradually improved. The next day, the patient developed epigastric pain and was diagnosed with acute myocardial infarction of the lower wall. After percutaneous coronary intervention, the patient's problems were partially regressed. Two days after the cardiac intervention, the patient went into sudden cardiac arrest with unsuccessful cardiopulmonary resuscitation. Acute myocardial infarction complicating ischemic stroke causes increase in patients` morbidity and mortality despite adequate and timely diagnosis and therapy.

Keywords: ischemic stroke, acute myocardial infarction, intravenous thrombolysis, mechanical thrombectomy, coronarography, percutaneous coronary intervention.

Received: April 11, 2020; Revised: May 6, 2020; Accepted: May 10, 2020; Published: June 16, 2022  Show citation