Urgent thrombolysis followed by percutaneous coronary intervention for the simultaneous acute cardio-cerebral ischemic attack: A case report

Figure 1 The electrocardiography shows anterior myocardial infarction. A: The electrocardiography (ECG) at the time of admission, with a typical ST-segment elevation in leads V1–V5, indicating anterior myocardial infarction; B: Three hours after admission, a repeat ECG shows anterior ST-elevation myocardial infarction, with no significant difference from the initial ECG, suggesting the unsuccessful recanalization of the culprit coronary artery.

Figure 2 The magnetic resonance imaging shows acute ischemic stroke. A and B: Diffusion-weighted magnetic resonance imaging reveals subtle scattered ischemic changes at the right frontal lobe and both parietal lobes; C: Magnetic resonance angiography shows an incomplete basilar artery ring and the absence of bilateral posterior communicating arteries.

Figure 3 Percutaneous coronary intervention was successfully performed. A: The coronary angiogram revealed 100% occlusion of the mid-left anterior descending (LAD) artery; B: Percutaneous transluminal coronary angioplasty was performed at the LAD artery with unsuccessful recanalization. The residual diameter stenosis was 80%-90%; C: After stenting, the coronary angiogram shows LAD artery with thrombolysis in myocardial infarction grade 3 flow.