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Cardiac sequelae of acute stroke

M G Myers, J W Norris, V C Hachinski

    Stroke
    |November 1, 1982
    PubMed
    Summary

    Acute stroke can lead to serious cardiac arrhythmias and myocardial damage, potentially due to increased sympathetic tone. This study highlights the cardiac risks associated with stroke, emphasizing the need for monitoring.

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    Area of Science:

    • Cardiology
    • Neurology
    • Critical Care Medicine

    Background:

    • Acute stroke is a critical neurological event.
    • The link between stroke and cardiac abnormalities, particularly increased sympathetic tone, requires further investigation.
    • Understanding these connections is vital for patient management in stroke intensive care units (ICUs).

    Purpose of the Study:

    • To investigate the potential for acute stroke to increase sympathetic tone.
    • To examine resultant cardiac abnormalities in stroke patients.
    • To compare cardiac events in stroke patients versus non-stroke controls.

    Main Methods:

    • Conducted 24-hour Holter ECG monitoring in 100 stroke patients and 50 controls.
    • Measured serum cardiac enzymes and plasma norepinephrine concentrations within 48 hours of admission.
    • Analyzed data considering age, co-existing heart disease, and stroke location (cerebral hemispheres vs. brainstem).

    Main Results:

    • Stroke patients exhibited significantly more serious arrhythmias than controls (p < .001), even after matching.
    • Arrhythmias were more prevalent in older patients and those with cerebral hemisphere infarctions.
    • Elevated creatine kinase (CK) levels in stroke patients correlated with higher mean plasma norepinephrine concentrations.

    Conclusions:

    • Acute stroke can precipitate cardiac arrhythmias.
    • Stroke may induce myocardial cell damage, possibly mediated by increased sympathetic tone.
    • These findings underscore the significant cardiac implications of acute stroke.

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