Acute Ischemic Stroke and STEMI in A 78-Year-Old Female: A Case Report of Dual Life-Threatening Events and Complicated Recovery

Abstract

Ischemic stroke and ST-elevation myocardial infarction (STEMI) occurring at the same time, are very rare conditions that cause major difficulties in management and present high mortality rates. This manuscript brings into focus a 78-year-old woman who had known diabetes mellitus (DM), hypertension (HTN), dyslipidemia, and ischemic strokes in the past, who presented with focal neurological deficits in the form of sudden onset slurring of speech and facial asymmetry which on investigation revealed a large left middle cerebral artery (MCA) infarction. Few hours later she developed STEMI with ECG changes and raised troponin levels. The patient experienced respiratory difficulty for which the patient was intubated. A percutaneous intervention (PCI) was attempted with moderate results. Complications included heart failure, atrial fibrillation (AF), and septic shock due to a urinary tract infection (UTI) that delayed her discharge from the hospital. Nevertheless, the effective treatment and cooperation between cardiologists and neurologists, stabilized her condition. This case shows the challenges of managing dual pathology (stroke and STEMI simultaneously); therefore, early diagnosis and multidisciplinary management offer the best prognosis to realize optimal outcomes.