Simultaneous acute myocardial infarction, stroke and critical limb ischaemia: an unusual presentation requiring multidisciplinary approach.
Author
Simpson, Danielle LeeAffiliation
Sandwell and West Birmingham NHS TrustPublication date
2021-05-06Subject
Cardiology
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Show full item recordAbstract
We report the case of a 57-year-old man who presented overnight to a district general hospital as a primary percutaneous coronary intervention alert for an inferior ST elevation myocardial infarction. On presentation to cardiac catheterisation lab, he had ongoing chest pain but began to complain of left-sided limb weakness and pain in his right leg. He was found to have dense hemiparesis on examination with an National Institute of Health Stroke Scale of 8 and an absent right femoral pulse. During the procedure, his common iliac arteries were imaged showing a complete occlusion of his right common iliac. After stenting the culprit lesion in his right coronary artery, he was transferred to a different hospital within the trust where he could receive thrombolysis for his stroke. Unfortunately, after thrombolysis, he went on to develop haemorrhagic transformation of his stroke and an upper gastrointestinal bleed with prolonged recovery of his neurological symptoms after a 27-day hospital stay; but CT arterial imaging showed resolution of right common iliac occlusion predischarge. Here, we discuss the best possible approach to management with simultaneous thrombotic eventsCitation
Simpson DL. Simultaneous acute myocardial infarction, stroke and critical limb ischaemia: an unusual presentation requiring multidisciplinary approach. BMJ Case Rep. 2021 May 6;14(5):e241565. doi: 10.1136/bcr-2021-241565.Type
ArticleOther
PMID
33958362Publisher
BMJ Publishing Groupae974a485f413a2113503eed53cd6c53
10.1136/bcr-2021-241565