title: Stunned myocardium following ischemic stroke. Case report.
abstract: 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.
authors.affiliation: Department of Cardiology, Santo António General Hospital, Oporto Hospital Center, Porto, Portugal. vascoalvesdias@hotmail.com
authors.forename: Vasco
authors.initials: V
authors.lastname: Dias
authors.forename: Sofia
authors.initials: S
authors.lastname: Cabral
authors.forename: Ana
authors.initials: A
authors.lastname: Meireles
authors.forename: Catarina
authors.initials: C
authors.lastname: Gomes
authors.forename: Nuno
authors.initials: N
authors.lastname: Antunes
authors.forename: Miguel
authors.initials: M
authors.lastname: Vieira
authors.forename: Luísa
authors.initials: L
authors.lastname: Caiado
authors.forename: Severo
authors.initials: S
authors.lastname: Torres
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D017682:Myocardial Stunning / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D020521:Stroke / Q000150:complications*; D015899:Tomography, Emission-Computed, Single-Photon