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How Is Stroke Related To Heart Disease?

Brain attack, or more commonly known as stroke, occurs when blood supply to the brain is interrupted. It is usually caused by a blockage of a brain blood vessel or bleeding when a brain blood vessel bursts. Blood carries oxygen and nutrients to the brain and when the blood supply is cut off, brain cells die causing brain damage.

It is common for heart problems including heart attack, congestive heart failure, abnormal heart rhythms, and cardiac arrest to occur immediately after a stroke. These heart problems may be caused by the stroke itself, or by the same underlying process that induced the stroke (most commonly, thrombosis of an artery), or the heart problem may occur first to cause the stroke (often seen when atrial fibrillation produces an embolus to the brain).

Nearly 13 percent of stroke victims aged 60 or older will have a heart attack within 3 days of the stroke. A research that looked at a group of 846 patients for 3 months after they suffered a stroke reported that more than 1 in 3 had a serious cardiac event in that time, and over 4 percent died. Although neurological damage is the most common cause of death after a stroke, cardiac complications rank second. The study was published in 2007 in the journal ‘Stroke’.

Published March 28, 2011 in journal ‘Stroke’, a study revealed that patients who have had temporary stroke symptoms known as a transient-ischemic attack (TIA) have twice the risk of heart attack as the general population. TIA patients who had a subsequent heart attack were 3 times more likely to die during the 20-year study than those who did not have a heart attack.

Heart failure can result if a stroke is accompanied by a heart attack. The stroke itself can directly cause weakening of the heart by producing a dramatic increase in adrenaline levels. These changes can cause significant cardiac ischemia (lack of oxygen in the heart muscle) even in people without coronary heart disease. The heart damage caused by this “neurologically-mediated” cardiac ischemia tends to be permanent. And it is common in young, healthy people who have stroke due to subarachnoid hemorrhage. “Cardiac stunning”, in which a portion of heart muscle suddenly stops working normally, may develop after stroke. This condition, also called “broken heart syndrome,” can produce episodes of severe, but temporary, heart failure.

During the first few days, significant cardiac arrhythmias are seen in 25 percent of patients admitted to the hospital with acute stroke. Atrial fibrillation is the most frequently occurred arrhythmia, which accounts for more than half of stroke-related heart rhythm problems. Life-threatening arrhythmias including ventricular fibrillation and cardiac arrest may also occur. Significant bradycardia (slow heart rate) can happen after a stroke, too. Usually the bradycardia is transient, though occasionally significant heart block may happen, requiring insertion of a pacemaker.

While it is unclear why acute heart attacks and acute strokes often occur together,
it is likely that some people who have atherosclerosis may go through periods of time in which the risk of thrombosis at the site of any atherosclerotic plaque is particularly high. Because plaques are often found in arteries supplying both the heart and the brain, during such high-risk times strokes and heart attacks may occur nearly simultaneously.

Meanwhile, some of the chemical changes caused by a stroke may affect the heart's functioning. For example, chemicals in the brain released into the bloodstream after a stroke may harm the heart. A stroke can also directly damage parts of the brain that control the heart. Right hemisphere damage makes serious heart rhythm problems and death caused by sudden stop of heart is more likely to happen.

Therefore, it is paramount for doctor to pay extra attention to and sort out the cause-and-effect for stroke patients who may be complicated by a heart problem so that the most effective therapy could be chosen to hasten recovery and prevent more problems in the future.




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