Acute Ischemic Stroke with Acute Myocardial Infarction, Neurologist or Cardiologist First? A Rarely Reported Case

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Published: Jan 24, 2024
DOI: https://doi.org/10.47191/ijmscrs/v4-i01-24
Keywords:
Cardio-cerebral Infarction, AIS, AMI

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Chandra Agung Maulana, MD
Siti Khadijah Islamic Hospital, Palembang, South Sumatra, Indonesia
Septo Andry Soesanto, MD
Department of Cardiology & Vascular Medicine, Mohammad Hoesin General Hospital, Palembang, South Sumatra, Indonesia
Muhamad Ikhsan Nurmansyah, MD
Department of Cardiology & Vascular Medicine, Mohammad Hoesin General Hospital, Palembang, South Sumatra, Indonesia
Rido Mulawarman, MD
Prabumulih General Hospital, Prabumulih, Indonesia
Monica Trifitriana, MD
Faculty of Medicine, Sriwijaya University, Palembang, South Sumatra, Indonesia
Rizca Yunanda, MD
Siti Khadijah Islamic Hospital, Palembang, South Sumatra, Indonesia
Edrian Zulkarnain, MD
Siti Khadijah Islamic Hospital, Palembang, South Sumatra, Indonesia

Abstract

A 51-year-old man presented to the hospital with right-sided paresis, reported within 1 hour of onset, and a National Institutes of Health Stroke Scale score of 4. Initial evaluation revealed elevated blood pressure, a heart rate of 120 bpm, and electrocardiography indicating sinus rhythm with anteroseptal wall infarction. Computed tomography confirmed cerebral infarction, particularly in the temporal lobe, and elevated Troponin I levels, suggesting cardiac involvement. The neurologist initiated intravenous Actilyse and Manitol, and the patient was admitted to the intensive care unit with a subsequent referral to a cardiologist. Cardiologist-approved interventions included Furosemide and Morphine due to emerging left chest discomfort. The patient experienced somnolence, leading to additional prescriptions of subcutaneous Diviti and oral Carvedilol. By the third day, the patient regained consciousness, and chest discomfort alleviated. Days four to five marked minimal chest discomfort, with improved right-sided muscle strength. Physiotherapy was initiated, and echocardiography revealed ischemic cardiomyopathy with left atrial and ventricular dilatation, anteroseptal and apical akinesia, mild mitral regurgitation, and a 23% ejection fraction. Thrombus in the left ventricular apex was identified. After day 8, the patient was discharged home.

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Chandra Agung Maulana, MD, Septo Andry Soesanto, MD, Muhamad Ikhsan Nurmansyah, MD, Rido Mulawarman, MD, Monica Trifitriana, MD, Rizca Yunanda, MD, & Edrian Zulkarnain, MD. (2024). Acute Ischemic Stroke with Acute Myocardial Infarction, Neurologist or Cardiologist First? A Rarely Reported Case. International Journal of Medical Science and Clinical Research Studies, 4(01), 107–110. https://doi.org/10.47191/ijmscrs/v4-i01-24
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Vol. 4 No. 01 (2024): Volume 04 Issue 01 January 2024
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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

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