Acute myocardial infarction and transient ischemic attack in a patient with lone atrial fibrillation and normal coronary arteries

Chlapoutakis, G.; Kafkas, Nikolaos; Katsanos, S; Kiriakou, Loukas G.; Floros, Georgios; Mpampalis, Dimitrios K.

doi:10.1016/j.ijcard.2008.06.085

Cited by 14 publications

(5 citation statements)

References 28 publications

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“…To the best of our knowledge, this is the first report of concurrent cerebral and coronary embolism diagnosed with brain magnetic resonance imaging and coronary angiography. Although combined transient ischemic attack and acute myocardial infarction in a patient with atrial fibrillation was reported in one previous study,11) they did not diagnose the embolism with imaging studies. The possibility of combined coronary embolism in a patient with acute embolic stroke as a rare etiology should be kept in mind, especially when there is evidence of acute myocardial infarction.…”

Section: Discussionmentioning

confidence: 84%

Simultaneously Presented Acute Ischemic Stroke and Non-ST Elevation Myocardial Infarction in a Patient with Paroxysmal Atrial Fibrillation

et al. 2013

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Although atrial fibrillation is the most frequent cause of embolic stroke, coronary embolism from atrial fibrillation is a very rare cause of acute myocardial infarction. Therefore, simultaneously presented acute ischemic stroke and acute myocardial infarction due to atrial fibrillation in the same patient has not been documented. The present report describes the case of a 58-year-old man with paroxysmal atrial fibrillation who initially presented with a large cerebral infarction due to embolic occlusion of the left middle cerebral artery. Four hours after the diagnosis of cerebral embolism, he was subsequently diagnosed with acute myocardial infarction due to concurrent coronary embolism. He underwent successful coronary revascularization with a drug-eluting stent. The possibility of combined coronary embolism as a rare etiology should be kept in mind when a patient with acute embolic stroke presents, especially when there is evidence of acute myocardial infarction.

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Section: Discussionmentioning

confidence: 84%

Simultaneously Presented Acute Ischemic Stroke and Non-ST Elevation Myocardial Infarction in a Patient with Paroxysmal Atrial Fibrillation

et al. 2013

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“…In patients with atrial fibrillation, embolization to both coronary and cerebral arteries has also been documented [ 12 ]. Similarly, a paradoxical embolus originating from a right ventricular thrombus or deep vein thrombosis through a patent foramen ovale is also a possibility [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

The Simultaneous Occurrence of Acute ST-Elevation Myocardial Infarction, Acute Ischemic Stroke, and Pulmonary Embolism

Lodeen,

Esmati,

Okan

et al. 2023

Cureus

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Acute ST-elevation myocardial infarction (STEMI), acute ischemic stroke (AIS), and acute pulmonary embolism (PE) are life-threatening conditions, each posing a high risk of morbidity and mortality. When all three of these acute conditions occur simultaneously, the overall prognosis for the patient becomes considerably worse. We report a case of a 70-year-old woman who presented to the emergency department (ED) with a triad of acute STEMI, AIS, and PE as a consequence of atherosclerotic heart disease, atrial fibrillation, and a prolonged transatlantic flight. The diagnoses were promptly confirmed through emergent coronary and cerebral angiography, along with a computerized tomography pulmonary angiogram (CTPA). The patient underwent a combination of medical therapy and endovascular thrombectomy. However, she later developed a subarachnoid hemorrhage and eventually progressed to brain death.

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“…A case of embolization to the coronary and cerebral arteries with atrial fibrillation has been also reported. [4] Adrenergic surge associated with stroke may result in catecholamine-induced myocardial stunning associated with takotsubo syndrome that may mimic STelevation AMI. Takotsubo syndrome also forms thrombus [2] which may cause CCI.…”

Section: Discussionmentioning

confidence: 99%

A case of cardiac tamponade during the treatment of simultaneous cardio-cerebral infarction associated with atrial fibrillation – Case report

Katsuki¹,

Katsuki²

2019

Surgical Neurology International

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Background: Simultaneous cerebral and myocardial infarction is called cardio-cerebral infarction (CCI). It is a rare condition, and its management strategy has yet to be determined. We report a case of cardiac tamponade during the treatment of CCI associated with atrial fibrillation. Case Description: A 72-year-old man presented with loss of consciousness after chest discomfort. He had taken rivaroxaban for paroxysmal atrial fibrillation. Twelve-lead electrocardiography showed ST elevation at II, III, and aVF. His National Institutes of Health Stroke Scale was 29. We diagnosed him with synchronous cardioembolic stroke and acute myocardial infarction due to atrial fibrillation. The coronary angiography revealed distal occlusion in the posterior descending branch of the right coronary artery, and overall myocardial perfusion seemed sufficient. The diffusion-weighted image showed hyperintense lesions at the cerebellum, and magnetic resonance angiography did not reveal the flow of the basilar artery. The patient’s NIH score improved immediately, so we did not perform intravenous tissue plasminogen activator (IV-tPA) administration nor endovascular treatment. Heparin administration was started. After 38 h from the onset, he suffered from hydrocephalus, and cerebral ventricular drainage was performed. Subsequently, circulatory dynamics worsened, and he was diagnosed with cardiac tamponade. Emergency pericardiotomy was performed, and he has been taking intensive care. Conclusion: Some cases with CCI treated with IV-tPA and endovascular intervention were reported, but the treatment strategy should be still discussed multidisciplinary. Especially, the administration of antithrombotic drugs for CCI should be carefully performed because fatal hemorrhage such as cardiac tamponade can occur.

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Acute myocardial infarction and transient ischemic attack in a patient with lone atrial fibrillation and normal coronary arteries

Cited by 14 publications

References 28 publications

Simultaneously Presented Acute Ischemic Stroke and Non-ST Elevation Myocardial Infarction in a Patient with Paroxysmal Atrial Fibrillation

Simultaneously Presented Acute Ischemic Stroke and Non-ST Elevation Myocardial Infarction in a Patient with Paroxysmal Atrial Fibrillation

The Simultaneous Occurrence of Acute ST-Elevation Myocardial Infarction, Acute Ischemic Stroke, and Pulmonary Embolism

A case of cardiac tamponade during the treatment of simultaneous cardio-cerebral infarction associated with atrial fibrillation – Case report

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