A patient with ischemic stroke and myocardial infarction undergoing interventional treatment - a case report

Abstract

The coexistence of acute ischemic stroke and acute myocardial infarction is rare. The reperfusion therapy used in the therapeutic window is the golden standard in the treatment of both diseases. We present a case of successful aspiration thrombectomy circumflex anterior artery and effective mechanical thrombectomy of the right internal carotid artery in a 49 - year-old female patient with myocardial infarction and ischemic stroke. When admitted in a neurological examination she received 16 points. on the NIHSS scale. The patient was discharged from the clinic as an independent, with slight hemiparesis (NIHSS 4 points). The result of recanalization was 3 points in the TICI scale. After intravascular treatment, the patient was advised to use anticoagulant therapy due to arterial thrombosis in two vascular areas and a high probability of thrombophilia until complete diagnostics. During the hospitalization, cardiovascular diseases were diagnosed. Transesophageal echocardiography showed a left-right flow through Botallio foramen width of 3 mm, with no visible reversal of leakage after contrast administration. After 3 months, tests were performed that did not confirm thrombophilia. The question of closing the surviving Botallio foramen, re-performing Holter and further genetic testing remains to be considered.