Myocardial
Infarction
About 3-4 % of people who have a myocardial infarction (MI) will go
on to have an embolic stroke. The risk of stroke is far greatest in the first
month following an MI.
Relationship
to stroke pathogenesis
Since atherosclerosis is the underlying
pathology in both MI and most ischemic strokes, this relationship should not be
a surprise. Furthermore, an MI may produce damage to the heart wall or persistent
atrial fibrillation, both of which promote thrombus formation. Bits of thrombus
may break off and embolize the brain. Finally, thrombolytic agents used to treat
an MI by breaking up clot in the coronary vessels increase the risk of intracerebral
hemorrhage.
A
little about control/treatment
Many of the risk factors for stroke and MI are the same. Therefore, preventing
a second MI or a stroke will involve many of the same considerations. These may
include lifestyle changes such as smoking cessation, increasing physical activity,
moderation of alcohol consumption, increasing fruits/vegetables and decreasing
fat in the diet Medical therapies that may be indicated include blood pressure
lowering medications, antiplatelet agents, anticoagulants if cardiac problems
that increase the risk of thrombus formation are present, lipid-lowering agents,
and medical treatment of diabetes mellitus if it is present.
