A 67-year-old male patient in Ho Chi Minh City who suffered both acute myocardial infarction and acute intracerebral hemorrhage was successfully saved thanks to a concurrent inferior stemi with third-degree AV block and acute intracranial haemorrhage. This rare case has just been published in the European Heart Journal – Case Reports, a medical journal of the European Society of Cardiology (ESC).
Dr. Le Duy Lac, Head of the Interventional Cardiology Unit in the Department of Cardiovascular Intensive Care of Thu Duc General Hospital, said yesterday that the case report was accepted for publication after eight months of international peer review and evaluation. The article is also indexed on PubMed, the U.S. National Institutes of Health (NIH) database, making it accessible to the global medical community.
According to Dr. Lac, the patient, with a history of hypertension, was admitted with impaired consciousness and right-sided weakness. MRI confirmed acute intracerebral hemorrhage. One hour later, the patient suddenly developed dyspnea, hypotension, and bradycardia. Electrocardiography revealed acute ST-elevation myocardial infarction complicated by third-degree atrioventricular block.
The greatest challenge was that the two conditions required opposing treatment regimens: myocardial infarction requires anticoagulants and antiplatelet therapy, while intracerebral hemorrhage contraindicates them. Facing this critical dilemma, the cardiology and neurology teams opted for coronary intervention without stent placement—performing only balloon angioplasty and thrombus aspiration, avoiding anticoagulants—in order to save the heart while minimizing the risk of worsening cerebral bleeding. After three days, once the brain condition stabilized, physicians proceeded with stent implantation under intravascular ultrasound guidance.
Dr. Vu Tri Thanh, Director of Thu Duc General Hospital, emphasized that this achievement not only saved the patient’s life but also contributed valuable scientific evidence to global medical literature on managing rare comorbid cardio-neurological emergencies. He noted that the case underscores the hospital’s commitment to scientific research, identified as one of its seven strategic priorities.
