Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
29 Jan 2021
29 Jan 2021
Historique:
received:
26
09
2020
accepted:
07
01
2021
entrez:
3
2
2021
pubmed:
4
2
2021
medline:
7
2
2021
Statut:
ppublish
Résumé
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. We present an overview of 5 cases of simultaneous cardio-cerebral infarction that we encountered in our emergency department within 1 month. In all cases, diagnosis was confirmed using an electrocardiogram, assessment of laboratory cardiac markers, and imaging. 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. 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. 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.
Identifiants
pubmed: 33530272
doi: 10.1097/MD.0000000000024496
pii: 00005792-202101290-00122
pmc: PMC7850703
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e24496Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interest to disclose.
Références
Chin Med J (Engl). 2017 May 5;130(9):1129-1130
pubmed: 28469112
Stroke Vasc Neurol. 2020 Sep;5(3):279-284
pubmed: 32616524
Virus Res. 2008 Apr;133(1):4-12
pubmed: 17825937
Curr Drug Targets. 2017;18(11):1301-1313
pubmed: 27469342
Cold Spring Harb Perspect Biol. 2009 Dec;1(6):a001651
pubmed: 20457564
Free Radic Biol Med. 2005 Jun 1;38(11):1433-44
pubmed: 15890617
J Neurol Neurosurg Psychiatry. 2020 Aug;91(8):846-848
pubmed: 32354770
JAMA Neurol. 2020 Jun 1;77(6):683-690
pubmed: 32275288
Neurol Neurochir Pol. 2018 Mar;52(2):168-173
pubmed: 28985991
Cell. 2008 Apr 18;133(2):235-49
pubmed: 18423196
Int J Antimicrob Agents. 2020 May;55(5):105954
pubmed: 32234467
J Clin Neurosci. 2020 Jul;77:227-229
pubmed: 32409210
Life Sci. 2006 Apr 4;78(19):2166-71
pubmed: 16303146
Curr Drug Targets. 2006 Jun;7(6):675-81
pubmed: 16787167
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
BMC Neurol. 2019 Jul 5;19(1):152
pubmed: 31277605
Hypertension. 2020 Jul;76(1):16-22
pubmed: 32367746
Life Sci. 2020 Sep 1;256:117900
pubmed: 32502542
J Neurol. 2020 Aug;267(8):2179-2184
pubmed: 32458193
Hypertension. 2013 Mar;61(3):681-9
pubmed: 23266545
BMJ Case Rep. 2011 Jun 03;2011:
pubmed: 22693314
Am J Case Rep. 2019 Jun 02;20:776-779
pubmed: 31154453
Autoimmun Rev. 2020 Jul;19(7):102573
pubmed: 32387470
ACS Chem Neurosci. 2020 Apr 1;11(7):995-998
pubmed: 32167747
N Engl J Med. 1997 Jan 23;336(4):251-7
pubmed: 8995087
Stroke. 2016 Feb;47(2):581-641
pubmed: 26696642
J Am Coll Cardiol. 2020 May 12;75(18):2352-2371
pubmed: 32201335
Ann Transl Med. 2018 Jan;6(1):7
pubmed: 29404353
Front Cell Dev Biol. 2019 Aug 07;7:154
pubmed: 31448275
Nat Med. 2020 Jul;26(7):1070-1076
pubmed: 32514174
Microbiol Mol Biol Rev. 2012 Mar;76(1):16-32
pubmed: 22390970
J Thromb Haemost. 2020 Aug;18(8):1995-2002
pubmed: 32369666
Cytokine. 2004 Nov 21-Dec 7;28(4-5):152-7
pubmed: 15588688
Curr Cardiol Rev. 2010 Aug;6(3):150-61
pubmed: 21804774
JAMA. 2020 May 12;323(18):1775-1776
pubmed: 32203977
Can J Cardiol. 2020 Jul;36(7):1068-1080
pubmed: 32425328
Transl Stroke Res. 2020 Jun;11(3):322-325
pubmed: 32378030
Front Neurol. 2017 Dec 07;8:664
pubmed: 29270151
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
J Stroke Cerebrovasc Dis. 2016 Jul;25(7):1797-1799
pubmed: 27105568
Stroke. 2018 Mar;49(3):e46-e110
pubmed: 29367334
Neuropharmacology. 2014 Apr;79:550-8
pubmed: 24440367
J Thromb Thrombolysis. 2017 Jul;44(1):104-111
pubmed: 28220330
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094
Eur J Biochem. 1994 Aug 1;223(3):1019-26
pubmed: 8055942
Brain Behav Immun. 2020 Jul;87:149
pubmed: 32387508
Int Arch Med. 2010 Oct 26;3:25
pubmed: 20977759
Lancet Haematol. 2020 Jun;7(6):e438-e440
pubmed: 32407672
JAMA. 2020 May 12;323(18):1843-1844
pubmed: 32159775
J Thromb Haemost. 2020 Aug;18(8):2031-2033
pubmed: 32464707
MMWR Morb Mortal Wkly Rep. 2020 Mar 27;69(12):343-346
pubmed: 32214079
Physiol Rev. 1994 Jan;74(1):139-62
pubmed: 8295932