CASE SERIES THE DIVERSITY OF CARDIAC DEATHS IN ISCHEMIC STROKE IN A TERTIARY NEUROLOGY CENTRE
DOI:
https://doi.org/10.32896/cvns.v5n4.1-8Keywords:
cardiac, Acute ischemic strokeAbstract
Cardiac complications in brain injury is a well-documented phenomenon. The spectrum of abnormalities includes hypertension, hypotension, ECG changes, cardiac arrhythmias, release of biomarkers of cardiac injury, and left ventricular (LV) dysfunction.1 This case series is a retrospective review of the confirmed cardiac deaths over a period of twelve months in patients who were admitted to our center for ischemic stroke. Ten patients were identified as confirmed cardiac deaths out of the 76 patients who died whilst being treated for a stroke. All the patients included in this case series had at least two out of three of the following- symptoms suggestive of myocardial injury, new or evolving ECG changes and a rise in cardiac markers from baseline. Nine out of ten were males. Three were known to have a pre-existing heart condition. The management for the stroke syndrome itself is outside the scope of this review.
References
REFERENCES
Tamsin Gregory, MBBS MRCP FRCA, Martin Smith, MBBS FRCA FFICM, Cardiovascular complications of brain injury, Continuing Education in Anaesthesia Critical Care & Pain, Volume 12, Issue 2, April 2012, Pages 67–71, https://doi.org/10.1093/bjaceaccp/mkr058
Samuels MA. The brain-heart connection. Circulation. 2007 Jul 3;116(1):77-84. doi: 10.1161/CIRCULATIONAHA.106.678995. PMID: 17606855.
Battaglini, D., Robba, C., Lopes da Silva, A. et al. Brain–heart interaction after acute ischemic stroke. Crit Care 24, 163 (2020). https://doi.org/10.1186/s13054-020-02885-8
Nguyen H, Zaroff JG. Neurogenic stunned myocardium. Curr Neurol Neurosci Rep. 2009 Nov;9(6):486-91. doi: 10.1007/s11910-009-0071-0. PMID: 19818236.
Xiong L, Tian G, Leung H, Soo YOY, Chen X, Ip VHL, et al. Autonomic dysfunction predicts clinical outcomes after acute ischemic stroke: a prospective observational study. Stroke. 2018;49:215–8.
S Meyer, M Strittmatter, C Fischer, T Georg, B Schmitz. Lateralization in autonomic dysfunction in ischemic stroke involving the insular cortex. Neuroreport, 15 (2004), pp. 357-361
S Laowattana, SL Zeger, JA Lima, SN Goodman, IS Wittstein, SM Oppenheimer. Left insular stroke is associated with adverse cardiac outcome. Neurology, 66 (2006), pp. 477-483.
Ay H, Koroshetz WJ, Benner T, Vangel MG, Melinosky C, Arsava EM, et al. Neuroanatomic correlates of stroke-related myocardial injury. Neurology 2006;66:1325-9.
Hartmann A, Rundek T, Mast H, Paik MC, Boden-Albala B, Mohr JP, Sacco RL. Mortality and causes of death after first ischemic stroke: the Northern Manhattan Stroke Study. Neurology. 2001 Dec 11;57(11):2000-5. doi: 10.1212/wnl.57.11.2000. PMID: 11739816.
Raed A. Joundi, Alejandro A. Rabinstein, Davar Nikneshan, Jack V. Tu, Jiming Fang, Robert Holloway, Gustavo Saposnik,Cardiac Arrest in Acute Ischemic Stroke: Incidence, Predisposing Factors, and Clinical Outcomes,Journal of Stroke and Cerebrovascular Diseases,Volume 25, Issue 7,2016,Pages 1644-1652,https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.03.010.
Prosser J, MacGregor L, Lees KR, Diener HC, Hacke W, Davis S; VISTA Investigators. Predictors of early cardiac morbidity and mortality after ischemic stroke. Stroke. 2007 Aug;38(8):2295-302. doi: 10.1161/STROKEAHA.106.471813. Epub 2007 Jun 14. PMID: 17569877.
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