Cardiac Complications in Acute Ischemic Stroke

Overview

Journal West J Emerg Med

Specialty Emergency Medicine

Date 2012 Jan 7

PMID 22224130

Citations 29

Authors

Charles R Wira 3rd

Emanuel Rivers

Cynthia Martinez-Capolino

Brian Silver

Gayathri Iyer

Robert Sherwin

Christopher Lewandowski

Affiliations

Soon will be listed here.

Abstract

Introduction: To characterize cardiac complications in acute ischemic stroke (AIS) patients admitted from an urban emergency department (ED).

Methods: Retrospective cross-sectional study evaluating AIS patients admitted from the ED within 24 hours of symptom onset who also had an echocardiogram performed within 72 hours of admission.

Results: Two hundred AIS patients were identified with an overall in-hospital mortality rate of 8% (n = 16). In our cohort, 57 (28.5%) of 200 had an ejection fraction less than 50%, 35 (20.4%) of 171 had ischemic changes on electrocardiogram (ECG), 18 (10.5%) of 171 presented in active atrial fibrillation, 21 (13.0%) of 161 had serum troponin elevation, and 2 (1.1%) of 184 survivors had potentially lethal arrhythmias on telemetry monitoring. Subgroup analysis revealed higher in-hospital mortality rates among those with systolic dysfunction (15.8% versus 4.9%; P = 0.0180), troponin elevation (38.1% versus 3.4%; P < 0.0001), atrial fibrillation on ECG (33.3% versus 3.8%; P = 0.0003), and ischemic changes on ECG (17.1% versus 6.1%; P = 0.0398) compared with those without.

Conclusion: A proportion of AIS patients may have cardiac complications. Systolic dysfunction, troponin elevation, atrial fibrillation, or ischemic changes on ECG may be associated with higher in-hospital mortality rates. These findings support the adjunctive role of cardiac-monitoring strategies in the acute presentation of AIS.

Citing Articles

Cardiac Findings Following Cerebrovascular Disease.

Rohner MD M, Gebhard C, Luft A, Hansel M, Wegener S J Am Heart Assoc. 2024; 13(17):e034131.

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Atrial Cardiomyopathy Predicts the Functional Outcome and Mortality in Stroke Patients.

Liu X, Wang Y, Ding L, Hu R, Zhang Y, Zhang W J Atheroscler Thromb. 2024; 31(10):1416-1426.

PMID: 38644203 PMC: 11456353. DOI: 10.5551/jat.64756.

Fan X, Cao J, Li M, Zhang D, El-Battrawy I, Chen G Adv Sci (Weinh). 2024; 11(14):e2307698.

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Diagnostic Methods in Forensic Pathology: Autoptic Findings and Immunohistochemical Study in Cases of Sudden Death Due to a Colloid Cyst of the Third Ventricle.

Montana A, Busardo F, Tossetta G, Goteri G, Castaldo P, Basile G Diagnostics (Basel). 2024; 14(1).

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The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy-A Review.

Ziaka M, Exadaktylos A J Stroke. 2023; 25(1):39-54.

PMID: 36592971 PMC: 9911836. DOI: 10.5853/jos.2022.02173.

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