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Related Experiment Videos

Neurogenic ST depression in stroke.

H C Chua1, S Sen, R F Cosgriff

  • 1Department of Neurology, The Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA. hschua@signet.com.sg

Clinical Neurology and Neurosurgery
|June 1, 1999
PubMed
Summary

Stroke can cause ST depression due to brain injury. This case shows neurogenic ST depression linked to a left insular infarct, highlighting the brain

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Area of Science:

  • Neuroscience
  • Cardiology
  • Neurology

Background:

  • Stroke is linked to ECG repolarization changes like ST depression.
  • A neurogenic contribution to these abnormalities in stroke patients is increasingly recognized.
  • The insular cortex plays a role in cardiovascular control, as shown in animal studies.

Observation:

  • A patient with a left insular infarct and no cardiac history experienced transient ST depression.
  • Cardiac evaluations, including Holter monitoring, echocardiography, and cardiac enzymes, were normal.
  • The ST depression was transient, non-reproducible, and lacked associated cardiac symptoms.

Findings:

  • The findings suggest neurogenic ST depression associated with the left insular infarct.
  • Normal adenosine thallium scan, non-reproducibility, and evanescence of ST changes support a neurogenic origin.

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  • The absence of cardiac symptoms and normal cardiac workup further indicate a non-cardiac etiology.

    • Implications:

    • Neurogenic ST depression may arise from insular cortex lesions.
    • This condition could potentially worsen cardiac outcomes when co-occurring with coronary artery disease.
    • Understanding the brain-heart axis is crucial for managing stroke patients with ECG abnormalities.