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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Acute right insular ischaemic lesions and poststroke left ventricular dysfunction.

Klemens Winder1,2, Carolina Villegas Millar1, Gabriela Siedler1

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Acute ischemic stroke can cause myocardial injury. This study found that damage to specific right-brain areas, particularly the insula, is linked to impaired left ventricular ejection fraction (LVEF) after stroke.

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Area of Science:

  • Neuroscience
  • Cardiology
  • Medical Imaging

Background:

  • Myocardial injury is common in acute ischemic stroke, even without prior heart disease.
  • The brain-heart axis plays a crucial role in cardiovascular regulation.
  • Understanding stroke-related cardiac dysfunction is vital for patient outcomes.

Purpose of the Study:

  • To investigate the association between left ventricular ejection fraction (LVEF) and the location of ischemic stroke lesions.
  • To identify specific brain regions involved in stroke-induced cardiac impairment.

Main Methods:

  • Retrospective analysis of 231 acute ischemic stroke patients without pre-existing heart disease.
  • Echocardiography to assess LVEF; categorization of impaired LVEF.
  • Multivariate voxelwise lesion analysis to correlate LVEF with lesion sites.

Main Results:

  • 40 patients (17.3%) had impaired LVEF post-stroke.
  • Impaired LVEF was associated with larger infarct volumes, troponin elevation, and atrial fibrillation.
  • Decreased LVEF correlated with lesions in the right insula, amygdala, and operculum.

Conclusions:

  • The right hemispheric central autonomic network, particularly the insular cortex, is implicated in the brain-heart axis.
  • Acute ischemic stroke in these brain regions can directly impair cardiac function.
  • These findings support the concept of a distinct stroke-heart syndrome.