Treatment of acute myocardial infarction as an early postoperative event after total gastrectomy and distal oesophagectomy for invasive gastric adenocarcinoma

Acute myocardial infarction (AMI) following major upper gastrointestinal surgery is rare yet associated with high mortality. Balancing timely revascularization with the risk of postoperative bleeding presents a significant clinical challenge, especially considering the altered pharmacokinetics of dual antiplatelet therapy after gastrectomy. The goal of our case report is to demonstrate the course of treating acute myocardial infarction in a patient with stable angina and arterial hypertension, previously surgically treated for aneurysm of the abdominal aorta, yet undergoing extensive radical surgery for locally advanced malignant disease. Interventional treatment decisions had been evolving and were in concordance with the patient's symptom status, ECG changes, repeated rhythm disorders, and extensive coronary artery disease. A multidisciplinary individual approach is essential to optimize outcomes and reduce the risk of haemorrhagic complications.