Stroke Hemodinamik Akibat Infark Miokard Akut

Vita Kusuma Rahmawati*, Achmad Firdaus Sani**, Mochamad Yusuf Assegaf***
* Peserta PPDS-1 Departemen Neurologi FK Universitas Airlangga/RSUD Dr. Soetomo Surabaya
** Staf Pengajar Departemen Neurologi FK Universitas Airlangga/RSUD Dr. Soetomo Surabaya
*** Staf Pengajar Departemen Kardiologi dan Kedokteran Vaskular FK Universitas Airlangga/RSUD Dr. Soetomo Surabaya

Abstract

         Pendahuluan: Kejadian stroke akibat infark miokard akut (IMA) berhubungan dengan morbiditas dan mortalitas tinggi. Stroke yang terjadi dapat terkait mikroemboli atau akibat hipoperfusi, yang disebut dengan stroke hemodinamik. Adanya infark miokard menyebabkan kegagalan pompa jantung dan penurunan aliran darah menuju otak (hipoperfusi). Laporan Kasus: Dilaporkan satu kasus laki-laki usia 56 tahun dengan stroke yang terjadi dalam waktu kurang dari 24 jam setelah kejadian infark miokard akut. Penderita datang dengan penurunan kesadaran, disartria akut, dan keluhan motorik double
hemiparesis. CT scan kepala tanpa kontras menunjukkan adanya infark di area perbatasan sistem pembuluh darah serebral bilateral. Kondisi klinis penderita membaik setelah dilakukan tindakan intervensi kardiak percutaneous coronary intervention (PCI). Diberikan terapi medikasi dual antiplatelet pasca tindakan PCI, yaitu aspirin 100 mg dan klopidogrel 75 mg per oral per hari. Stroke yang terjadi pada penderita adalah stroke hemodinamik akibat IMA. Kesimpulan: Tindakan intervensi kardiak PCI memperbaiki vaskularisasi pembuluh darah koroner, namun juga merupakan faktor risiko terjadinya stroke. Pencegahan terhadap terjadinya stroke yang berhubungan dengan tindakan intervensi kardiak perlu dilakukan mengingat stroke merupakan komplikasi yang sangat merugikan setelah tindakan PCI.

Kata kunci:
Dual antiplatelet, Hipoperfusi, Infark miokard akut, Stroke hemodinamik.

Daftar Pustaka

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