Cardiac Complications After a Stroke

The major consequences of a stroke are neurological changes, but cardiac (heart) problems may also complicate stroke recovery.

Man talking to nurse, holding chest
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A study published in the journal Stroke looked at a group of 93,627 patients for one year after they experienced a stroke. The risk of having a major heart incident within 30 days after a stroke was 25 times higher in women and 23 times higher in men. One year after a stroke, men and women were still twice as likely to experience a major heart event than peers who had not had a stroke.

Although neurological damage is the most common cause of death after a stroke, cardiac complications rank second.

Common Cardiac Problems Following a Stroke

In the days immediately following a stroke, heart attack, congestive heart failure, abnormal heart rhythms, and cardiac arrest are more likely to occur.

Abnormal heart rhythms, including atrial fibrillation and atrial flutter, are particularly common. In both of these conditions, the atria (upper chambers of the heart) function in a way that isn't normal.

  • If you have atrial fibrillation, your heartbeat will be irregular. 
  • With atrial flutter, the rhythm of your heartbeat will be regular, but too rapid.

Both conditions are dangerous and affect the blood flow throughout the body.

Additionally, irregular heart rhythms can cause blood to pool in the atria, leading to blood clot formation. If clots move into the bloodstream, they may end up in the coronary arteries (where they could cause a heart attack) or the brain (where they could cause another stroke).

Having a Stroke Increases a Person's Risk for Cardiac Trouble

Some of the same risks that can lead to a stroke can also make heart problems more likely. These factors include high blood pressure, diabetes, high cholesterol, coronary artery disease, and heart arrhythmias.

Some of the physical changes caused by a stroke may affect heart function. For example, chemicals released into the bloodstream after a stroke may be harmful to the heart.

Sometimes, a stroke can directly damage parts of the brain that control the heart. For example, right hemisphere damage due to a stroke can lead to serious heart rhythm problems, increasing the risk of and death.

Prevention of Cardiac Problems After Stroke

Recent recommendations have suggested continuous heart monitoring for one to three days after a stroke to identify developing cardiac problems.

Risk factors that may prompt your medical team to monitor your heart after a stroke include:

  • Age over 75 years old
  • Having had a major stroke
  • History of one or more of the following conditions: Diabetes, congestive heart failure, high blood pressure, previous stroke, or coronary artery disease
  • High levels of serum creatinine, which is produced when muscle breaks down
  • High troponin levels. Troponin is a protein found in the heart muscle; it is released into the bloodstream when cells in the heart are injured or destroyed.
  • High systolic blood pressure
  • Changes in the results of an electrocardiogram, which measures what's going on in your heart— especially abnormal rhythm changes, early, extra beats of the ventricles of the heart, and atrial fibrillation and flutter.
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  3. Mitchell, LB. Atrial fibrillation and atrial flutter. Merck Manual Consumer Version. Kenilworth, NJ: Merck & Co., Inc.; 2019.