Interventional treatment of concomitant acute myocardial infarction and stroke: a case report

    Authors

    Keywords

    acute myocardial infarction, cerebrovascular insult, interventional treatment, health care plan

    DOI

    https://doi.org/10.15836/ccar2018.493

    Full Text

    Introduction : This case report presents a patient with arterial hypertension initially examined in the Surgical Emergency Unit because of a head contusion as a consenquence of a mild traffic accident due to a syncope preceded by chest pain. Case presentation : After thorough evaluation, patient was diagnosed with an acute ST elevation myocardial infarction of the inferoposterior wall, and since the patient was somnolent and had neurological deficits (anisocoria and left-sided hemiparesis), CT angiography of the cerebral arteries was performed, and acute ischemic cerebrovascular insult was also verified. Immediately afterwards, coronary angiography was performed and triple vessel disease with the occlusion of the right coronary artery was found. During the same procedure, a percutaneous coronary intervention was performed with the implantation of 3 stents in the residual stenosis of the right coronary artery. Subsequently, an endovascular procedure, superselective DSA, was performed and the occlusion of the posterior cerebral artery and superior cerebellar artery was confirmed. Immediately, an intervention with thromboaspiration and mechanical removal of thromboembolic material was performed. The patient was hospitalized at the Intensive Cardiac Care Unit, Department of Cardiovascular Diseases, University Hospital Centar “Sestre milosrdnice” and during the hospitalization there was a complete regression of symptoms and complete neurological recovery. Through an appropriately set up health care plan, identifying nursing problems in the patient, and appropriate healthcare interventions, the set goal during the patient’s hospitalization has been successfully achieved. Experienced skills, combined with knowledge, helped a team of nurses and technicians to prevent a possibility of creating a new nursing problem by implementing interventions through a set health care plan. During further hospitalization, the patient was cardiopulmonally compensated, afebrile, without neurological deficit. Conclusion : This paper shows that it is possible to adequately and successfully treat patients with concurrent acute myocardial infarction if there is a possibility for an accurate and prompt use of complicated diagnostic and therapeutic procedures. ( 1 , 2 )

    Cardiologia Croatica
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    Interventional treatment of concomitant acute myocardial infarction and stroke: a case report

    Extended Abstract
    Issue11-12
    Published
    Pages493
    PDF via DOIhttps://doi.org/10.15836/ccar2018.493
    acute myocardial infarction
    cerebrovascular insult
    interventional treatment
    health care plan

    Authors

    Renata Čosić*ORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Tomislav PijetlovićORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Valentina VarmužORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Ivana BenkovićORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Božica LeškoORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Jadranka DaskijevićORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Lidija BanORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Ivica BenkoORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Ivana TomašićORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia

    Full Text

    Introduction : This case report presents a patient with arterial hypertension initially examined in the Surgical Emergency Unit because of a head contusion as a consenquence of a mild traffic accident due to a syncope preceded by chest pain. Case presentation : After thorough evaluation, patient was diagnosed with an acute ST elevation myocardial infarction of the inferoposterior wall, and since the patient was somnolent and had neurological deficits (anisocoria and left-sided hemiparesis), CT angiography of the cerebral arteries was performed, and acute ischemic cerebrovascular insult was also verified. Immediately afterwards, coronary angiography was performed and triple vessel disease with the occlusion of the right coronary artery was found. During the same procedure, a percutaneous coronary intervention was performed with the implantation of 3 stents in the residual stenosis of the right coronary artery. Subsequently, an endovascular procedure, superselective DSA, was performed and the occlusion of the posterior cerebral artery and superior cerebellar artery was confirmed. Immediately, an intervention with thromboaspiration and mechanical removal of thromboembolic material was performed. The patient was hospitalized at the Intensive Cardiac Care Unit, Department of Cardiovascular Diseases, University Hospital Centar “Sestre milosrdnice” and during the hospitalization there was a complete regression of symptoms and complete neurological recovery. Through an appropriately set up health care plan, identifying nursing problems in the patient, and appropriate healthcare interventions, the set goal during the patient’s hospitalization has been successfully achieved. Experienced skills, combined with knowledge, helped a team of nurses and technicians to prevent a possibility of creating a new nursing problem by implementing interventions through a set health care plan. During further hospitalization, the patient was cardiopulmonally compensated, afebrile, without neurological deficit. Conclusion : This paper shows that it is possible to adequately and successfully treat patients with concurrent acute myocardial infarction if there is a possibility for an accurate and prompt use of complicated diagnostic and therapeutic procedures. ( 1 , 2 )