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2019, Número 2

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Cardiovasc Metab Sci 2019; 30 (2)


Infarto sincrónico cardio-cerebral no hiperagudo tratado con doble terapia intervencionista

Plata-Corona JC, Cerón-Morales JA, Lara-Solís B

Idioma: Inglés [English version]
Referencias bibliográficas: 40
Paginas: 66-75
Archivo PDF: 363.29 Kb.


RESUMEN

Introducción: La aparición simultánea de infarto agudo de miocardio y evento vascular cerebral isquémico es conocida como infarto cardiocerebral (ICC), esta asociación es extremadamente infrecuente y representa un escenario complejo de cara al tratamiento. En estos casos generalmente hay una causa subyacente que vincula ambos eventos trombóticos. El reconocimiento simultáneo de estas dos condiciones es difícil en términos clínicos, y en muchos de los casos se llega a demostrar únicamente mediante autopsia. Objetivos: En la presente revisión se aborda la epidemiología, fisiopatología y el tratamiento del ICC dentro de la literatura actual. Caso clínico: Masculino de 46 años, diagnosticado de ICC después de cinco horas de iniciado su cuadro clínico, decidimos realizar un doble abordaje percutáneo con trombólisis intraarterial más trombectomía mecánica de la arteria cerebral media derecha asociada a coronariografía con angioplastia y colocación de stent en el segmento proximal de la arteria descendente anterior. Resultados: La recuperación del paciente fue favorable, egresándose al tercer día sin datos de falla cardiaca y con Rankin score modificado de 2, y de 0 al mes. Conclusión: El ICC es poco común y con frecuencia devastador. Se necesitan más estudios para establecer estrategias adecuadas de tratamiento, sin embargo, la rareza de esta condición hace difícil establecer ensayos clínicos para su estudio. Basados en los resultados obtenidos en este caso en particular, sugerimos un abordaje endovascular combinado en pacientes con ICC sincrónico no hiperagudo.


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