Management Challenges in Concurrent Acute Myocardial Infarction and Ischemic Stroke: A Case Series and Literature Review

Abstract

Concurrent acute myocardial infarction and acute ischemic stroke, termed cardiocerebral infarction (CCI), is a rare but critical emergency that presents major diagnostic and therapeutic challenges. We report a case series of three patients presenting with concurrent CCI, highlighting the variability in clinical presentation and the complexity of acute management. The cases illustrate diverse clinical presentations; variable temporal relationships between cardiac and neurological events; and complex management decisions involving thrombolysis, primary percutaneous coronary intervention, and antithrombotic therapy. Multidisciplinary collaboration between cardiology and neurology teams was essential in balancing the competing risks of hemorrhage and ongoing ischemia. This case series highlights the absence of standardized management guidelines for CCI and underscores the need for individualized, case-based decision-making in this high-risk clinical scenario.