[Elevation of the ST segment and positive troponin T as a sign of myocardial damage in acute stroke].

History and Admission Findings: A 77-year-old woman suffered an ischemic stroke during an operation, which under narcosis became apparent by large variations in blood pressure. At the same time a myocardial infarction was suspected due to typical ST segment elevations and positive troponin T in the serum.
Investigations and Diagnosis: The CT scan showed a right sided medial ischemic stroke. The myocardial infarction could not be confirmed by coronary angiography. Nevertheless, myocardial damage was clearly confirmed by ECG, echocardiography as well as the typical course of cardiac markers in the blood. An ischemic stroke with direct myocardial damage was diagnosed.
Treatment and Course: Under conservative treatment the ECG and cardiac markers in the blood normalized. However, the contractile dysfunction in the affected cardiac segment remained.
Conclusion: Patients with stroke have a high cardiac morbidity and mortality. Especially in acute stroke, cardiac pathology has been linked to an impaired central autonomic regulation. This should be considered in the diagnostic routine to identify those patients with acute stroke that would benefit from an early treatment with cardio-protective medications.