Chest Pain and Arrhythmias in the Neurointensive Care Unit

There are common cardiac presentations of neurologic disease including chest pain and arrhythmias that are seen in the neurointensive care unit. Cardiac causes of chest pain include myocardial infarction, hypertensive emergency/urgency, and aortic dissection. Cardiac chest pain is frequently provoked by neurologic injury, a consequence of the brain–heart interaction. Acute neurologic chest pain in the neurointensive care unit can also have a noncardiac origin. There are ECG changes that are frequently seen with neurologic emergencies, including repolarization abnormalities and dysrhythmias, such as bradyarrhythmias and tachyarrhythmias.