Akuter ischämischer Schlaganfall und Troponinerhöhung: Diagnostische Abklärung und therapeutische Konsequenzen

Zusammenfassung

Erhöhte Troponinwerte beim akuten ischämischen Schlaganfall sind ein häufiges klinisches Szenario, das vor dem Hintergrund der hohen kardialen Mortalität nach Schlaganfall eine angemessene diagnostische Aufarbeitung erfordert. Zur Vermeidung sekundärer intrazerebraler Hämorrhagien durch duale Thrombozytenaggregationshemmung sollte die Indikation zur Koronarintervention streng gestellt werden. Anhand dreier Fallbeispiele stellt diese Arbeit auf Grundlage der vorhandenen Evidenz einen diagnostischen Algorithmus vor.

Abstract

Elevated troponin values are frequently detected in patients with acute ischemic stroke, requiring adequate diagnostic work-up due to the high cardiac mortality after stroke. Since dual platelet inhibition can cause secondary intracerebral hemorrhage careful consideration of invasive coronary intervention is mandatory. Based on three case reports, this review article presents a diagnostic algorithm taking into account latest findings from the literature.

Schlüsselwörter

koronare Herzkrankheit - Myokardinfarkt - Koronarangiografie - zerebrale Infarktgröße - sekundäre intrazerebrale Hämorrhagie

Keywords

coronary heart disease - myocardial infarction - coronary angiography - cerebral infarction size - secondary intracerebral hemorrhage

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