Cardiac troponin may elevate after a stroke due to what mechanism?

Cardiac troponin may elevate after a stroke due to what mechanism?

• A. Acute MI only
• B. Renal failure causing troponin leakage
• C. Autonomic dysfunction
• D. Sepsis

Answer: (C)

Autonomic dysfunction after a stroke can trigger a surge of sympathetic activity that directly affects the heart. This neurogenic surge releases a flood of catecholamines, causing coronary vasospasm and myocardial stunning or injury. The heart muscles become transiently distressed, releasing troponin even when there isn’t an occluded coronary artery. This neurogenic cardiac injury explains troponin elevation following stroke. Renal failure or sepsis can also raise troponin for separate reasons, but the post-stroke mechanism most closely tied to this context is the autonomic-driven myocardial injury that arises from brain–heart autonomic dysregulation.

Autonomic dysfunction after a stroke can trigger a surge of sympathetic activity that directly affects the heart. This neurogenic surge releases a flood of catecholamines, causing coronary vasospasm and myocardial stunning or injury. The heart muscles become transiently distressed, releasing troponin even when there isn’t an occluded coronary artery. This neurogenic cardiac injury explains troponin elevation following stroke.

Renal failure or sepsis can also raise troponin for separate reasons, but the post-stroke mechanism most closely tied to this context is the autonomic-driven myocardial injury that arises from brain–heart autonomic dysregulation.