![]() CCI poses a clinical challenge for physicians including (1) optimal strategies to enable swift mechanical reperfusion to both the brain and myocardium (2) difference in dosage of thrombolytics for AIS versus AMI (3) risk of symptomatic intracerebral hemorrhage following administration of anticoagulation and/or antiplatelet therapy and (4) caution with use of thrombolytics in the setting of acute STEMI due to the risk of myocardial rupture. Ultimately, all three patients passed away. The two patients that did not receive thrombolysis were treated with modified therapeutic heparin (no bolus), and all received antiplatelet therapy. Percutaneous intervention (PCI) was done in only one case. Fibrinolysis and mechanical thrombectomy (MT) were discussed in all cases, but only one patient received alteplase (0.9 mg/kg) and none underwent MT. All three patients presented with symptomatic left MCA (M1) occlusion, with ST elevation myocardial infarction (STEMI) and left ventricular apical thrombus. Each disease requires timely intervention to prevent irreversible damage however, optimal management remains unclear. CCI is a rare clinical presentation of simultaneous acute ischemic stroke (AIS) and acute myocardial infarction (AMI) and poses a therapeutic challenge for practitioners. The objective of this manuscript is to describe the challenges of Cardio-Cerebral Infarction (CCI) treatment and to highlight the variable approaches in management. ![]()
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