Therapy » Brain stroke as a «mask» of acute myocardial infarction

Brain stroke as a «mask» of acute myocardial infarction

DOI: https://dx.doi.org/10.18565/therapy.2023.5.16-24

Plotnikov D.M., Alifirova V.M., Antipova S.G., Romadina N.Yu.
1) Siberian State Medical University of the Ministry of Healthcare of Russia, Tomsk; 2) Tomsk Regional Clinical Hospital

Abstract. Acute myocardial infarction and acute cerebrovascular accident (ACV) are the two most severe diseases of the cardiovascular system, which are accompanied by the highest mortality. The risk of a poor outcome increases exponentially when there are signs of both myocardial infarction and stroke. However, even if there is a specific clinic, both of them are not always really present in patients: on the one hand, clinical, instrumental and laboratory signs of myocardial infarction can be detected in patients with a stroke, on the other hand, a cerebral stroke clinic can be a «mask» of an acute infarction myocardium (so-called cerebral form of a heart attack). The present study is dedicated to this particular form of myocardial infarction: we analyzed lethal clinical cases when patients were admitted with obvious signs of stroke to the Regional vascular center for CVA patients of Tomsk regional clinical hospital. During pathoanatomical examination the acute myocardial infarction was verified in them, but was no confirmation of ischemic stroke diagnosis.
The aim: to study the features of clinic, laboratory and instrumental studies of patients having ischemic stroke clinic as a «mask» of myocardial infarction.
Material and methods. Case histories and results of post-mortem examinations of 50 patients who met the selection criteria were analyzed.
Results. On the ground of a retrospective study, typical diagnostic pitfalls were found and the most specific clinical, laboratory and instrumental signs of the cerebral form of myocardial infarction were identified.
Conclusion. Taking into account the most typical clinical, instrumental and laboratory signs in patients with a brain stroke clinic may allow more confident differentiation of the two most severe diseases of the cardiovascular system – acute myocardial infarction and ischemic brain stroke. This may contribute to more rapid and timely treatment tactics, which will give patients a chance for specialized treatment methods for their curation.

Keywords: ischemic brain stroke, pseudo-stroke, cerebral form of myocardial infarction

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About the Autors

Denis M. Plotnikov, PhD in Medical Sciences, neurologist at the epidemiological monitoring office of the Regional vascular center for CVA patients, Tomsk Regional Clinical Hospital, professor of the Department of neurology and neurosurgery, Siberian State Medical University of the Ministry of Healthcare of Russia. Address: 634012, Tomsk, 6a-5 Kosareva Str. E-mail: dmarkych@gmail.com. ORCID: https://orcid.org/0000-0002-5528-1634
Valentina M. Alifirova, MD, professor, head of the Department of neurology and neurosurgery, Siberian State Medical University of the Ministry of Healthcare of Russia, chief consultant neurologist at Tomsk region Healthcare Department. Address: 634050, Tomsk, 2 Moskovsky Trakt Str. E-mail: v_alifirova@mail.ru. ORCID: https://orcid.org/0000-0002-4140-3223
Svetlana G. Antipova, cardiologist at the Department of anesthesiology and resuscitation of the regional vascular center for CVA patients, Tomsk Regional Clinical Hospital. Address: 634012, Tomsk, 6a-5 Kosareva Str. E-mail: svetlana.g.antipova1982@gmail.com
Natalia Yu. Romadina, head of the neurological Department of the Regional vascular center for CVA patients, Tomsk Regional Clinical Hospital. Address: 634012, Tomsk, 6a-5 Kosareva Str. E-mail: 400502@mail.ru

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