Stroke and myocardial infarction – parallels and paradoxes

Overview

Myocardial infarction and ischemic stroke are among the three most common causes of death. The peak of heart attack mortality was in the mid 60s. Since then the mortality curve has markedly declined. The death rate of cerebral ischemia is, for the most part, unchanging. Both disorders are of the same type and the same cause – atherosclerosis. The target organ is significantly different. All the advantages are on the myocardium side. Whereas in the treatment of cardiac infarction there has recently been great progress, in the case of stroke, traditional techniques are still prevalent and there has been minimal progress. The management of cardiac infarct is run by a closely linked team of cardiologists and cardiac surgeons. The management of stroke involves a large number of various specialities. Cardiovascular problems are overreported in comparison to cerebrovascular topics. Diagnosis, therapy and the timing of treatment of cardiac infarction have obvious criteria in contrast to stroke. It is necessary to underline parallels between angina pectoris and transient ischemic attack, which demand the same attention as stenocardia. It calls for a change of definition. The original formula is outdated and misleading. The therapeutic window between transient ischemic attack and completed stroke is shorter than initially presumed. The urgency of these findings supports metaanalyses of studies, shoving carotid endarterectomy markedly depends on time. The reason for this paper is to point out frequent parallels and especially paradox in the management of ischemic stroke and cardiac infarction.

Key words:
stroke, myocardial infarction, cerebrovascular disease, cardiovascular disease, transient ischemic attack