Myocardial involvement in acute cerebrovascular events is common and usually reversible, likely driven by catecholamine release rather than acute coronary thrombosis.
Clinicians should recognize reversible myocardial changes in cerebrovascular events to avoid misattributing to ACS; leaves open prospective outcome studies.
Signs of myocardial involvement are common in patients with acute cerebrovascular events. ST segment deviations, abnormal left ventricular function, increased N-terminal pro-brain natriuretic peptide (NT-proBNP), prolonged QT interval, and/or raised troponins are observed in up to one third of the patients. The huge majority of these findings are fully reversible. The changes may mimic myocardial infarction, but are not necessarily identical to coronary thrombosis. Based on the literature these signs may represent an acute catecholamine release provoked by the cerebrovascular catastrophe itself and not coronary thrombosis. However, all patients with signs of cardiac involvement during acute cerebrovascular events should receive a cardiological follow-up in order to exclude concomitant ischemic heart disease.
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Jespersen et al. (2007) studied this question.
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