Chennai: The 76-year-old woman came into the emergency room of a city hospital a month ago complaining of sudden weakness on one side of her body and slurred speech — the classic, unmistakable warnings of a brain stroke in progress. But when doctors ran their assessments, they found something far more complicated: her heart, too, was ailing. Its arteries critically narrowed and blood flow dangerously compromised.
In the hours that followed, neurologists at MGM Healthcare Malar Hospital moved her into the cath lab, where they removed a block deep inside the brain in the middle cerebral artery — the largest artery supplying the brain, responsible for movement, speech, and sensation on one side of the body — using a catheter guided through the groin. They then cleared the blockage in the carotid artery in the neck, the main vessel that carries blood from the heart to the brain. After this, cardiologists took over to remove the blocks in the coronary arteries that supply blood to the heart muscle.
Simultaneous stroke and acute cardiac events are not common in clinical literature, but their co-occurrence is not entirely surprising given risk factors including diabetes and age.
“Together, the neck and brain blockages triggered the stroke, while the coronary blockage put her at immediate risk of a heart attack,” said Dr S Karthikeyan, the hospital’s consultant interventional neurologist.
The team decided to address all three blockages in a single session rather than staging them across multiple procedures, avoiding the dangers of repeated anaesthesia, delayed intervention, and hemodynamic instability between procedures. “The 45-minute procedure helped us clear all the blocks. The patient was discharged in four days,” he said. On Wednesday, when she walked into the hospital for her one-month review, doctors found her fit. “She can manage most tasks on her own. She has no neurological deficits or cardiac complications,” he said.