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Case Report

Diagnostic Dilemma in a Case of Ischaemic CVA

Indraneel Dasgupta, Clinical Director and Head, Department of Emergency Medicine, Peerless Hospital & B.K.Roy Research Center, 360 Panchasayar, Kolkata - 700094, West Bengal. , Indraneel Dasgupta , Sayani Banerjee , Rudraneel Kumar

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Indian Journal of Emergency Medicine 3(1):p 126-129, January - June 2017. | DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3117.20

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Abstract

Background:A 72 years aged female patient presented with history of chest pain which was resolved with medication. Later she developed slurring of speech, weakness of left side of body, hoarseness of voice, deviation of mouth to right.Case presentation: Initial ECG had ST depressions and T inversion, bedside qualitative Trop-T was positive with a unremarkable CT brain plain even after 24 hours of onset of her symptoms suggestive of stroke, arouse a diagnostic dilemma for the emergency physician of coexisting NSTEMI with ischemic stroke in her case and patient was initially admitted under cardiology. Further work up ruled out NSTEMI and confirmed MCA territory acute ischaemic stroke. Conclusion: Acute stroke patients may have ischaemic changes and/or QT prolongation in ECG and elevated cardiac troponins, probably as a result of Neurogenic cardiac damage,which may arise diagnostic dilemma for the emergency physician as in this case and it shows prognostically poor outcome in acute stoke stroke patients.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3117.20

Keywords

Stroke; Troponin; Coronary Syndrome.

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