Heart problems are common in people who have astroke. Heart disease is a stroke risk factor, and heart problems can develop or worsen during the acute phase of the stroke, during the recovery period—and afterward.

If you’ve had a stroke, your healthcare team will closely monitor your heart condition and will also evaluate your heart health to ensure that you are getting the right treatment for any heart disease that you are diagnosed with.

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Types of Cardiac Problems Seen With Stroke

Heart problems that are common among people who have had a stroke include myocardial infarction (heart attack),heart failure, and cardiac arrhythmias—especiallyatrial fibrillation,ventricular tachycardia, and ventricular fibrillation.

Heart Problems That Go Hand in Hand With Strokes

Stroke and Myocardial Infarction

An acute stroke can make it difficult to perceive or communicate the symptoms of a heart attack, In the days after a stroke, you would be monitored carefully for signs of cardiac ischemia.This includes continuous ECG monitoring (cardiac telemetry) for the first few days and monitoring cardiac enzymes for signs of heart damage.

Treatment

Healthcare providers treating an acute heart attack will make sure that the patient is not also having a stroke before they use thrombolytic drugs (that is, “clot busters”). Thrombolytics are not a common treatment for acute myocardial infarction unless percutaneous coronary intervention (PCI) is not available (a procedure to open blocked or narrowed coronary arteries).

While dissolving a thrombosis in a coronary artery is often therapeutic, these treatments may lead to brain hemorrhage and a dramatic worsening of the stroke.

Most people who have survived a stroke or a heart attack need to take measures to reduce atherosclerotic disease. This includes medication and lifestyle modification.

Stroke and Heart Failure

Stroke can be associated with new or worsening heart failure. There are several reasons for this.

Stroke is also associated with transient “cardiac stunning,” in which a portion of heart muscle suddenly stops working normally. This condition can produce episodes of severe, but temporary, heart failure.

Stroke and Cardiac Arrhythmias

An arrhythmia is an irregular heart rate or rhythm. An arrhythmia can cause a stroke, and a stroke can also worsen or cause arrhythmias. Significant cardiac arrhythmias are seen during the first few days in 25% of patients admitted to the hospital withacute stroke.

The arrhythmia most frequently associated with stroke is atrial fibrillation, which accounts for more than half of stroke-related heart rhythm problems.

Life-threatening arrhythmias may also occur, including ventricular fibrillation and cardiac arrest. In many cases, such potentially lethal arrhythmias are due tolong QT syndrome, which may result from a stroke.

Significant bradycardia (slow heart rate) can also occur after a stroke. Usually, the bradycardia is transient, but occasionally significant heart block may be seen, requiring the insertion of a pacemaker.

Summary

Serious heart problems are common after a stroke. Anyone who’s had a stroke needs to be carefully evaluated and monitored for at least several days for the possibility of myocardial infarction, heart failure, andcardiac arrhythmias. And having a stroke often indicates that you are at high risk for future cardiac problems, so post-stroke care involves measures to reduce the risk of a recurrent stroke, as well as reducing the risk of heart problems.

The Difference Between a Stroke and a Heart Attack

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alqahtani F, Aljohani S, Tarabishy A, et al.Incidence and outcomes of myocardial infarction in patients admitted with acute ischemic stroke.Stroke.2017; 8:2931. doi:10.1161/STROKEAHA.117.018408Powers WJ, Rabinstein AA, Ackerson T, et al.Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke.2019; 50:e344. doi:10.1161/STR.0000000000000211Chen Z, Venkat P, Seyfried D, et al.Brain-heart interaction: Cardiac complications after stroke.Circ Res2017; 121:451. doi:10.1161/CIRCRESAHA.117.311170Morris NA, Chatterjee A, Adejumo OL, et al.The risk of takotsubo cardiomyopathy in acute neurological disease.Neurocrit Care.2019; 30:171. doi:10.1007/s12028-018-0591-zFernández-Menéndez S, García-Santiago R, Vega-Primo A, et al.Cardiac arrhythmias in stroke unit patients. Evaluation of the cardiac monitoring data.Neurologia.2016;31:289. doi:10.1016/j.nrl.2015.03.013Kamel H, Okin PM, Elkind MS, Iadecola C.Atrial fibrillation and mechanisms of stroke: Time for a new model.Stroke. 2016;47(3):895-900. doi:10.1161/STROKEAHA.115.012004

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alqahtani F, Aljohani S, Tarabishy A, et al.Incidence and outcomes of myocardial infarction in patients admitted with acute ischemic stroke.Stroke.2017; 8:2931. doi:10.1161/STROKEAHA.117.018408Powers WJ, Rabinstein AA, Ackerson T, et al.Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke.2019; 50:e344. doi:10.1161/STR.0000000000000211Chen Z, Venkat P, Seyfried D, et al.Brain-heart interaction: Cardiac complications after stroke.Circ Res2017; 121:451. doi:10.1161/CIRCRESAHA.117.311170Morris NA, Chatterjee A, Adejumo OL, et al.The risk of takotsubo cardiomyopathy in acute neurological disease.Neurocrit Care.2019; 30:171. doi:10.1007/s12028-018-0591-zFernández-Menéndez S, García-Santiago R, Vega-Primo A, et al.Cardiac arrhythmias in stroke unit patients. Evaluation of the cardiac monitoring data.Neurologia.2016;31:289. doi:10.1016/j.nrl.2015.03.013Kamel H, Okin PM, Elkind MS, Iadecola C.Atrial fibrillation and mechanisms of stroke: Time for a new model.Stroke. 2016;47(3):895-900. doi:10.1161/STROKEAHA.115.012004

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Alqahtani F, Aljohani S, Tarabishy A, et al.Incidence and outcomes of myocardial infarction in patients admitted with acute ischemic stroke.Stroke.2017; 8:2931. doi:10.1161/STROKEAHA.117.018408Powers WJ, Rabinstein AA, Ackerson T, et al.Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke.2019; 50:e344. doi:10.1161/STR.0000000000000211Chen Z, Venkat P, Seyfried D, et al.Brain-heart interaction: Cardiac complications after stroke.Circ Res2017; 121:451. doi:10.1161/CIRCRESAHA.117.311170Morris NA, Chatterjee A, Adejumo OL, et al.The risk of takotsubo cardiomyopathy in acute neurological disease.Neurocrit Care.2019; 30:171. doi:10.1007/s12028-018-0591-zFernández-Menéndez S, García-Santiago R, Vega-Primo A, et al.Cardiac arrhythmias in stroke unit patients. Evaluation of the cardiac monitoring data.Neurologia.2016;31:289. doi:10.1016/j.nrl.2015.03.013Kamel H, Okin PM, Elkind MS, Iadecola C.Atrial fibrillation and mechanisms of stroke: Time for a new model.Stroke. 2016;47(3):895-900. doi:10.1161/STROKEAHA.115.012004

Alqahtani F, Aljohani S, Tarabishy A, et al.Incidence and outcomes of myocardial infarction in patients admitted with acute ischemic stroke.Stroke.2017; 8:2931. doi:10.1161/STROKEAHA.117.018408

Powers WJ, Rabinstein AA, Ackerson T, et al.Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke.2019; 50:e344. doi:10.1161/STR.0000000000000211

Chen Z, Venkat P, Seyfried D, et al.Brain-heart interaction: Cardiac complications after stroke.Circ Res2017; 121:451. doi:10.1161/CIRCRESAHA.117.311170

Morris NA, Chatterjee A, Adejumo OL, et al.The risk of takotsubo cardiomyopathy in acute neurological disease.Neurocrit Care.2019; 30:171. doi:10.1007/s12028-018-0591-z

Fernández-Menéndez S, García-Santiago R, Vega-Primo A, et al.Cardiac arrhythmias in stroke unit patients. Evaluation of the cardiac monitoring data.Neurologia.2016;31:289. doi:10.1016/j.nrl.2015.03.013

Kamel H, Okin PM, Elkind MS, Iadecola C.Atrial fibrillation and mechanisms of stroke: Time for a new model.Stroke. 2016;47(3):895-900. doi:10.1161/STROKEAHA.115.012004

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