Simultaneous Acute Multiple Ischemic Strokes of the Left Cerebral Hemisphere and Signs of Acute Anterior STEMI: A Case Report

BACKGROUND Acute cerebral infarction and acute myocardial infarction are both common life-threatening conditions with high incidence rates. The simultaneous occurrence of these conditions is extremely rare. Most documented cases are limited to case reports, and no specific treatment guidelines have been established. Treatment strategies considerably vary among individuals; the prognosis is often poor, particularly in older patients. Studies of cardio-cerebral infarction are important to reduce mortality and disability. CASE REPORT A 62-year-old man was admitted to the hospital with right-sided limb weakness and inability to speak for more than 4 hours, without chest pain. Electrocardiographic findings were consistent with acute anterior ST-segment elevation myocardial infarction. Computed tomography angiography revealed acute occlusion of the left internal carotid artery, and magnetic resonance imaging demonstrated multiple infarctions in the left cerebral hemisphere. The patient had a National Institutes of Health Stroke Scale score of 13 and underwent emergency thrombectomy of the left internal carotid artery. He recovered well after the procedure, with only mild hemiplegia, and regained independence in activities of daily living. However, during the stable recovery phase, he suddenly experienced cardiac and respiratory arrest, resulting in death. CONCLUSIONS Although cardio-cerebral infarction is rare, it is associated with a very high mortality rate. Survivors often have poor outcomes, underscoring the need for greater clinical awareness. This case highlights the importance of early coronary artery evaluation even in patients with asymptomatic myocardial infarction, given that cardio-cerebral infarction can increase cardiogenic shock risk. The rehabilitation phase should also receive close attention, with appropriate monitoring to detect potentially fatal complications.