• Rawan Eskandarani, Seham Sahli, Shaima Sawan, and Asim Alsaeed.
• Emergency Medicine Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
• Medicine (Baltimore). 2021 Jan 29; 100 (4): e24496e24496.

IntroductionSimultaneous occurrence of acute ischemic stroke and myocardial infarction is reported to have variable precipitating causes. This occurrence has been rarely reported in the literature and described only in very few case reports. During the surge of coronavirus disease (COVID-19) in our region, we noted an increase in the simultaneous occurrence of cardio-cerebral infarction. This led us to explore the possible mechanisms and pathophysiology that could contribute to this increase. The retrospective nature of the study limited us from drawing any conclusion about causation. Rather, we aimed to formulate a hypothesis for future, more rigorous studies.Patient ConcernsWe present an overview of 5 cases of simultaneous cardio-cerebral infarction that we encountered in our emergency department within 1 month.DiagnosisIn all cases, diagnosis was confirmed using an electrocardiogram, assessment of laboratory cardiac markers, and imaging.InterventionsIn all cases, dual antiplatelet therapy was started and thrombolysis was held, as the condition was considered high risk in most of the patients. Cardiac catheterization lab was not activated either because the patient was unstable or the risk of COVID-19 in staff outweighed the benefit added in patient treatment.OutcomesTwo out of 5 patients died because of early complications that lasted for few days. The remaining 3 were discharged from the hospital in moderate functionality for extensive therapy and rehabilitation.ConclusionEarly recognition and immediate treatment is important in different scenarios leading to thrombosis as the outcome. Additionally, addressing the unknown risks that could contribute to our traditional understanding of these causative mechanisms is important. The hypothesis of exacerbated damage caused by inflammatory and immunological endothelial systemic damage should further be explored to be able to delineate new possibilities in managing these conditions.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

16 keywords...

hide…