Rapidly changing tachyarrhythmia in acute stroke

We report a 56-year-olds female with supraventricular arrhythmia due acute ischemic stroke without structural heart disease.

A patient presented with sudden onset of lethargy, right hemiplegia, and global aphasia. There was previous history of stroke 1 year ago presented with left hemiplegia that recovered completely during 10 days. There was no history of comorbid illness. The brain CT revealed extensive hypodensity in left temporoparietal region suggestive of infarct without midline shift. General examination revealed hypotension and bradycardia that treated with dopamine that gradually recovered during 5 days thus infusion of dopamine discontinued, and muscular power in paretic limbs and aphasia was recovered. In 6th day of admission electrocardiographic monitoring of patient showed a rapidly changing tachyarrhythmia including sinus tachycardia, atrial fibrillation, and atrial flutter that quickly interchanged to another, without hemodynamic instability and alteration in mental status. Laboratory tests and TEE study were normal. During 48 hour arrhythmia relived spontaneously.

Stroke can cause any type of cardiac arrhythmias that may not be constant.