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Semin Neurol 2021; 41(04): 331-339
DOI: 10.1055/s-0041-1726333
Review Article

Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management

Anusha Boyanpally 
1   Department of Neurology, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
,
Shawna Cutting
1   Department of Neurology, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
2   The Norman Prince Neuroscience Institute, Rhode Island Hospital, Providence, Rhode Island
,
Karen Furie
1   Department of Neurology, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
2   The Norman Prince Neuroscience Institute, Rhode Island Hospital, Providence, Rhode Island
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Abstract

Acute ischemic stroke (AIS) and acute myocardial infarction (AMI) may co-occur simultaneously or in close temporal succession, with occurrence of one ischemic vascular event increasing a patient's risk for the other. Both employ time-sensitive treatments, and both benefit from expert consultation. Patients are at increased risk of stroke for up to 3 months following AMI, and aggressive treatment of AMI, including use of reperfusion therapy, decreases the risk of AIS. For patients presenting with AIS in the setting of a recent MI, treatment with alteplase, an intravenous tissue plasminogen activator, can be given, provided anterior wall myocardial involvement has been carefully evaluated. It is important for clinicians to recognize that troponin elevations can occur in the setting of AIS as well as other clinical scenarios and that this may have implications for short- and long-term mortality.

Keywords

ischemic stroke - acute myocardial infarction - thrombolytic therapy - cerebral infarction - tissue plasminogen activator - percutaneous coronary intervention


Publication History

Article published online:
13 April 2021

© 2021. Thieme. All rights reserved.

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