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Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series

INTRODUCTION: Simultaneous 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 ou...

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Autores principales: Eskandarani, Rawan, Sahli, Seham, Sawan, Shaima, Alsaeed, Asim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850703/
https://www.ncbi.nlm.nih.gov/pubmed/33530272
http://dx.doi.org/10.1097/MD.0000000000024496
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author Eskandarani, Rawan
Sahli, Seham
Sawan, Shaima
Alsaeed, Asim
author_facet Eskandarani, Rawan
Sahli, Seham
Sawan, Shaima
Alsaeed, Asim
author_sort Eskandarani, Rawan
collection PubMed
description INTRODUCTION: Simultaneous 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 CONCERNS: We present an overview of 5 cases of simultaneous cardio-cerebral infarction that we encountered in our emergency department within 1 month. DIAGNOSIS: In all cases, diagnosis was confirmed using an electrocardiogram, assessment of laboratory cardiac markers, and imaging. INTERVENTIONS: In 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. OUTCOMES: Two 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. CONCLUSION: Early 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.
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spelling pubmed-78507032021-02-02 Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series Eskandarani, Rawan Sahli, Seham Sawan, Shaima Alsaeed, Asim Medicine (Baltimore) 3400 INTRODUCTION: Simultaneous 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 CONCERNS: We present an overview of 5 cases of simultaneous cardio-cerebral infarction that we encountered in our emergency department within 1 month. DIAGNOSIS: In all cases, diagnosis was confirmed using an electrocardiogram, assessment of laboratory cardiac markers, and imaging. INTERVENTIONS: In 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. OUTCOMES: Two 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. CONCLUSION: Early 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. Lippincott Williams & Wilkins 2021-01-29 /pmc/articles/PMC7850703/ /pubmed/33530272 http://dx.doi.org/10.1097/MD.0000000000024496 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 3400
Eskandarani, Rawan
Sahli, Seham
Sawan, Shaima
Alsaeed, Asim
Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
title Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
title_full Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
title_fullStr Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
title_full_unstemmed Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
title_short Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
title_sort simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: a case series
topic 3400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850703/
https://www.ncbi.nlm.nih.gov/pubmed/33530272
http://dx.doi.org/10.1097/MD.0000000000024496
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