TITLE:
Concomitant Acute Coronary Syndrome and Acute Ischemic Stroke: A Particular Association and a Therapeutic Dilemma
AUTHORS:
Junior Rocyr Ibara-Onguema, Khaoula Bourzeg, Franck Bienvenu Ekoba Othende, Mohammed El Jamili, Saloua El Karimi, Mustapha El Hattaoui
KEYWORDS:
Acute Ischemic Stroke, Acute Coronary Syndrome, Cardio Cerebral Infarction, Thrombolysis, Percutaneous Coronary Intervention
JOURNAL NAME:
Open Access Library Journal,
Vol.10 No.3,
March
30,
2023
ABSTRACT: Cardiocerebral infarction (CCI), defined as the concomitant occurrence of acute myocardial infarction (AMI) and acute ischaemic stroke (AIS), has been rarely reported in the literature. The aim of this manuscript is to describe the challenges in the treatment of CCI and to highlight the different approaches in the management of this entity. We report the case of two young women admitted to our cardiology department with acute coronary syndrome concomitant with stroke at different times and whose management differed according to their ischemic and hemorrhagic risk. It is assumed that there is a possible relationship between the two conditions rather than a mere coincidence. Explanations for this association are reviewed and discussed in detail in this paper. The management of a concurrent presentation of AIS and AMI is unclear. The use of antiplatelets and anticoagulants that are integral to the management of AMI may increase the risk of haemorrhagic transformation, and the use of a thrombolytic in AIS similarly increases the risk of heart wall rupture in AMI. As there are no large-scale studies, high quality evidence or clinical guidelines, the treatment of CCI should be highly individualized.