Stroke-heart syndrome – cardiac complications in ischemic stroke patients

Czech version

Authors: P. Mikulenka ¹; M. Mihalovič ²; T. Peisker ¹; P. Toušek ²; I. Štětkářová ¹
Authors‘ workplace: Neurologická klinika 3. LF UK a FN Královské Vinohrady, Praha ¹; Kardiologická klinika 3. LF UK a FN Královské Vinohrady, Praha ²
Published in: Cesk Slov Neurol N 2024; 87(2): 101-106
Category: Review Article
doi: https://doi.org/10.48095/cccsnn2024101

Overview

Patients with ischemic stroke face an increased risk of a broad range of cardiovascular complications. These may manifest as acute myocardial injury, acute coronary syndrome, left ventricular dysfunction (including Takotsubo syndrome). Furthermore, severe arrhythmias or sudden cardiac death may also occur. In addition to these clinically manifested complications, oligosymptomatic abnormalities such as elevation of specific biomarkers or ECG changes occur in some patients. These complications are associated with more severe neurological disability and higher mortality in patients with acute stroke. The diagnosis and treatment of cardiac complications in patients with stroke has its own specificities and depends mainly on the type of stroke. The pathophysiology of these complications remains partly unclear. According to the new concept of the stroke heart syndrome, it appears that, in addition to the traditional vascular risk factors, other underlying mechanisms, such as autonomic dysregulation or systemic inflammatory response arising as a consequence of brain tissue damage during stroke are involved in the development of early cardiac complications. Despite growing interest in this issue and new insights into its pathophysiology, specific therapies for this so-called stroke-heart syndrome are still lacking. In routine clinical practice, the role of the neurologist in the early diagnosis and treatment of cardiac complications in patients after acute stroke is crucial.

Keywords:

acute coronary syndrome – stroke – cardiac complications – cardiac arrhythmias – stroke-heart syndrome

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