Significance of cardiocoronary pathology in acute stroke

Abstract A number of non-neurological factors predict mortality of acute stroke other than the clinical severity. Over the last twenty five years or so evidence has accumulated that the acute stroke patients develop cardiological abnormalities which have frequently been considered as epi-phenomena. It has however become clear that the cardiological and coronary circulation abnormalities in acute stroke phase are not benign. There are abnormalities of heart rate and rhythm disturbance, abnormalitiy of cardiac function, evidence of cardiac injury as demonstrated by elevation of cardiological hormones, all of which contribute to higher mortality. More recently the evidence of a proportion of acute stroke patients dying due to unrecognised but established coronary disease has been reported signifying the link between common atheromatous disease risk factors for coronary and cerebral ischaemia. There is a rise in catecholamines in acute strokes which leads to a strain on already diseased myocardium. There is thus a need for directing attention to cardiac pathology in acute stroke and investigating measures that would support coronary circulation and cardiac function to improve their outcome.