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Simultaneous acute myocardial infarction, stroke and critical limb ischaemia: an unusual presentation requiring multidisciplinary approach
- Source :
- BMJ Case Rep
- Publication Year :
- 2023
-
Abstract
- 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 events.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Myocardial Infarction
Case Report
030204 cardiovascular system & hematology
Chest pain
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Internal medicine
medicine.artery
medicine
Humans
Myocardial infarction
Stroke
business.industry
Percutaneous coronary intervention
General Medicine
Middle Aged
medicine.disease
Coronary Vessels
Hemiparesis
Right coronary artery
Cardiology
Myocardial infarction complications
ST Elevation Myocardial Infarction
Myocardial infarction diagnosis
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 1757790X
- Volume :
- 14
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- BMJ case reports
- Accession number :
- edsair.doi.dedup.....d708b3f30bd4f6ac3c98985e68bed425