Acute ischemic stroke can present with elevated cardiac troponin T and ischemic ECG changes, necessitating a cardiac workup to rule out acute myocardial infarction.
May mimic ACS in stroke; hypothesis-generating for neurocardiogenic injury and needs prospective validation.
Cardiac troponin T (cTnT) is a highly sensitive and specific marker of myocardial necrosis that aid in diagnosis of myocardial infarction. cTnT elevations along with EKG changes noticed in patients with acute Stroke without major cardiac events. Case Report: We report the case of 87year female presented with cough, lethargy, decreased oral intake, shortness of breath, chest pain and altered mental status. Head CT scan of this patient did not reveal any acute intracranial pathology. Laboratory work showed cardiac troponin T elevation with ECG changes were concerning for cardiac ischemia.Careful examination was significant for right facial droop and right sided weakness. A repeat head computed tomography (CT scan) was obtained which showed acute stroke. Conclusion: Patient with ischemic stroke may have shown to have an association with elevated cTnT. They are at an increased risk of mortality from renal and/or cardiac failure. Though ECG changes and cTnT levels can be attributed to stroke, given the common risk factors shared by coronary artery disease and stroke, a cardiac work up is warranted to rule out any acute myocardial event or look up for the source of stroke which most likely to be cardiac.
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Bakhsh et al. (2015) studied this question.
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