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Case Reports: Learning from unexpected outcome (positive or negative)
Myocardial infarction after craniotomy for asymptomatic meningioma
  1. Kristen Michelle Westfall,
  2. Roger Navine Ramcharan and
  3. Harry Linne Anderson, III
  1. Surgery, St Joseph Mercy Ann Arbor, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Kristen Michelle Westfall; kristen.westfall{at}stjoeshealth.org

Abstract

A man in his 40s with a history of coronary artery disease previously treated with a drug-eluting stent presented for elective craniotomy and resection of an asymptomatic but enlarging meningioma. During his craniotomy, he received desmopressin and tranexamic acid for surgical bleeding. Postoperatively, the patient developed chest pain and was found to have an ST-elevation myocardial infarction (MI). Because of the patient’s recent neurosurgery, standard post-MI care was contraindicated and he was instead managed symptomatically in the intensive care unit. Echocardiogram on postoperative day 1 demonstrated no regional wall motion abnormalities and an ejection fraction of 60%. His presentation was consistent with thrombosis of his diagonal stent. He was transferred out of the intensive care unit on postoperative day 1 and discharged home on postoperative day 3.

  • Drug therapy related to surgery
  • Adult intensive care
  • Unwanted effects / adverse reactions
  • Neurosurgery
  • Ischaemic heart disease

https://doi.org/10.1136/bcr-2022-252256

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    Footnotes

    • Twitter @kwestfall23

    • Contributors KMW is the primary author who cared for the patient, contributed to the write up, and edited the manuscript. RNM cared for the patient, contributed to the discussion and edited the manuscript. HLA oversaw the patient’s care and edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.