Cardio-Cerebral Infarction Pathophysiology and Management
Summary
Cardio-cerebral infarction refers to the simultaneous occurrence of acute ischaemic stroke and myocardial infarction, a rare but life-threatening syndrome that unites two leading causes of mortality and disability worldwide. Pathophysiologically, shared mechanisms including cardiogenic embolism, systemic inflammation, endothelial dysfunction and hypercoagulable states create a milieu in which thrombi may lodge concurrently in cerebral and coronary arteries. Atrial fibrillation, prosthetic valves, malignancy and infection-induced endothelial injury have all been implicated as embolic sources. Management challenges centre on the competing time-sensitive windows for reperfusion of brain and heart, and on balancing haemorrhagic risk against myocardial salvage. Contemporary approaches advocate rapid multimodal imaging, multidisciplinary decision-making and tailored reperfusion strategies that may combine intravenous thrombolysis, mechanical thrombectomy and percutaneous coronary intervention. Emerging adjuncts such as remote ischaemic conditioning hold promise to attenuate ischaemia–reperfusion injury in both territories. Standardised protocols and close collaboration between stroke specialists and cardiologists are critical to improve outcomes and guide future trials in this complex, high-impact condition.
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Cardio-Cerebral Infarction Pathophysiology and Management publication trend
The graph below shows the total number of articles in cardio-cerebral infarction pathophysiology and management across all publications each year (not limited to Nature Index journals).
Technical terms
Cardio-cerebral infarction (CCI): the concurrent occurrence of acute myocardial infarction and acute ischaemic stroke.
Remote ischaemic conditioning (RIC): cycles of brief limb ischaemia applied to induce systemic protection against subsequent ischaemia–reperfusion injury.
Coronary artery embolism (CE): obstruction of a coronary vessel by an embolus originating away from the site of atherosclerotic plaque.
Reperfusion therapy: restoration of blood flow to ischaemic tissue using pharmacological thrombolysis or mechanical interventions such as thrombectomy and percutaneous coronary intervention.
References
- Remote ischemic conditioning reduces adverse events in patients with acute ischemic stroke complicating acute myocardial infarction: a randomized controlled trial. Critical Care (2024).
- Coronary artery embolism and acute coronary syndrome: A critical appraisal of existing data. Trends in Cardiovascular Medicine (2022).
- Concurrent acute myocardial infarction and acute ischemic stroke: Case reports and literature review. Frontiers in Cardiovascular Medicine (2022).
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