Cardiovascular Center, Seoul National University Boramae Medical Center, Seoul, Korea.
Korean Circ J. 2013 Nov;43(11):766-9. doi: 10.4070/kcj.2013.43.11.766. Epub 2013 Nov 30.
Although atrial fibrillation is the most frequent cause of embolic stroke, coronary embolism from atrial fibrillation is a very rare cause of acute myocardial infarction. Therefore, simultaneously presented acute ischemic stroke and acute myocardial infarction due to atrial fibrillation in the same patient has not been documented. The present report describes the case of a 58-year-old man with paroxysmal atrial fibrillation who initially presented with a large cerebral infarction due to embolic occlusion of the left middle cerebral artery. Four hours after the diagnosis of cerebral embolism, he was subsequently diagnosed with acute myocardial infarction due to concurrent coronary embolism. He underwent successful coronary revascularization with a drug-eluting stent. The possibility of combined coronary embolism as a rare etiology should be kept in mind when a patient with acute embolic stroke presents, especially when there is evidence of acute myocardial infarction.
尽管心房颤动是引起栓塞性中风最常见的原因，但心房颤动引起的冠状动脉栓塞却是急性心肌梗死的一个非常罕见的原因。因此，同一患者同时出现急性缺血性中风和急性心肌梗死尚未有文献记载。本报告描述了 1 例 58 岁阵发性心房颤动患者的病例，该患者最初因左大脑中动脉栓塞而出现大面积脑梗死。在诊断为脑栓塞 4 小时后，他被诊断为同时发生的冠状动脉栓塞导致的急性心肌梗死。他接受了药物洗脱支架的成功冠状动脉血运重建。当急性栓塞性中风患者出现时，特别是当有急性心肌梗死的证据时，应注意联合冠状动脉栓塞作为一种罕见病因的可能性。
