Insights into the pathophysiology of stroke-heart syndrome: a review of recent literature and clinical trials to illuminate promising therapeutic strategies

Abstract

Stroke heart syndrome (SHS) represents a complex interplay between cerebrovascular and cardiovascular pathophysiology, leading to significant morbidity and mortality. This review explores the mechanisms underlying SHS, highlighting neurogenic, inflammatory, and hemodynamic interactions that contribute to myocardial injury, arrhythmias, and heart failure post-stroke. A detailed examination of risk factors, including hypertension, atrial fibrillation, and metabolic disorders, underscores their role in predisposing individuals to SHS. The clinical manifestations of SHS, ranging from acute coronary syndromes to neurogenic cardiac injury, are reviewed, along with key diagnostic tools such as cardiac biomarkers, electrocardiographic changes, and imaging modalities. Emerging therapeutic strategies, including neuroprotective interventions, anticoagulation, and cardioprotective agents, are discussed in the context of optimizing patient outcomes. The integration of multidisciplinary care approaches, involving both neurologists and cardiologists, is crucial for mitigating the adverse consequences of SHS. Future research should focus on refining risk stratification models, developing targeted interventions, and exploring novel biomarkers to enhance the management of SHS.