Key result
A patient with ischemic stroke developed stunned myocardium mimicking acute myocardial infarction, with left-ventricular dysfunction persisting longer than usual despite full neurologic recovery.
Case Report (n=1)
Neuromediated stunned myocardium can occur following ischemic stroke and may present with prolonged left-ventricular dysfunction mimicking acute myocardial infarction.
Clinicians should consider neurogenic stunned myocardium in post-stroke LV dysfunction; single case leaves open incidence, duration, and management implications.
Neuromediated stunned myocardium is a well-known complication of subarachnoid hemorrhage but has rarely been reported in association with other central nervous system disorders. The pathophysiology of this entity remains unclear, but a catecholamine-induced neurocardiogenic injury has been proposed as a causal factor. Typically, patients have rapid full cardiovascular recovery within a few days. We report a case of ischemic stroke, coexisting with ischemic electrocardiographic changes, increased cardiac-specific necrosis biomarkers, regional wall motion abnormalities and a cardiac SPECT consistent with inferior myocardial infarction despite normal coronary arteries. Interestingly, left-ventricular dysfunction in this case persisted longer than usually described despite full neurologic recovery. This case also illustrates the diagnostic challenges posed by this entity which frequently mimics acute myocardial infarction and emphasizes the investigation needed in this area.
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Dias et al. (2009) conducted a case report in Ischemic stroke and stunned myocardium (n=1). Ischemic stroke was evaluated. A patient with ischemic stroke developed stunned myocardium mimicking acute myocardial infarction, with left-ventricular dysfunction persisting longer than usual despite full neurologic recovery.
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