Hyperacute Cardio-cerebral Infarction: a Therapeutic Challenge

Abstract

A 72-year-old woman was admitted to the Intensive Care Unit (ICU) with right-sided hemiparesis and mixed aphasia; an axial brain computed tomography (CT) with no acute injuries and the angiotomography showed a 50% stenosis of the intracranial left internal carotid. Presented a National institute of Health Stroke Scale (NIHSS) score of 23, whereby she received fibrinolytic treatment with endovenous tissue plasminogen activator (rTPA) 170 min after the symptoms started. An electrocardiogram (ECG) and echocardiogram revealed an acute myocardial infarction (MI) with a ST-segment elevation at the inferior face. After the fibrinolytic treatment, the patient presented criterion for myocardial reperfusion. She evolved favourably and was discharged from the ICU after 48 h with a NIHSS score of 9. The aim of the present case report is, therefore, to suggest a clinical approach to help physicians in the decision-making process for treatment in patients with concurrent hyperacute cardio-cerebral infarction (CCI).