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Akuter ischämischer Schlaganfall und erhöhter Troponinwert – Update des Mannheimer Algorithmus

  • Louisa Becker,
  • Angelika Alonso,
  • Mathieu Kruska,
  • Stefan Baumann,
  • Niklas Grassl,
  • Hendrik Lesch,
  • Philipp Eisele,
  • Tina Sieburg,
  • Michael Behnes,
  • Tobias Schupp,
  • Hany Kayed,
  • Michael Platten,
  • Daniel Duerschmied,
  • Kristina Szabo,
  • Ibrahim Akin,
  • Christian Fastner

摘要

Elevated high-sensitivity cardiac troponin (hs-cTn) levels should be expected in about half of all patients with acute ischemic stroke (AIS). Since those patients are at risk of increased morbidity and mortality, often attributable to cardiac causes, an adequate work-up of the underlying etiology is required. This can only be achieved by a team of cardiologists and neurologists. Since underlying causes of hs-cTn elevation in AIS patients are diverse, often atypical or silent in their clinical presentation and some, such as an accompanying myocardial infarction, can be acutely life-threatening, the work-up should follow a standardized clinical algorithm. The vast majority of hs-cTn elevations are caused by non-ischemic myocardial injury associated with AIS. This work presents a practice-oriented approach to differential diagnosis with the update of the Mannheim clinical algorithm for acute ischemic stroke and troponin elevation.