Stroke with sensory symptoms mimicking myocardial ischemia

Objective: To report five stroke patients with sensory deficits including prominent chest discomfort mimicking angina. Background: Chest wall sensory discomfort, as a part of unilateral sensory dysfunction, has seldom been recognized as a potential imitator of cardiac ischemia. Methods: A retrospective review of stroke patients with sensory symptoms from the New England Medical Center Stroke Registry. Results: As a part of an acute stroke that included unilateral sensory symptoms and signs, five patients had chest pain or discomfort, which prompted cardiac evaluation for potential coronary artery disease. In two patients, the primary presentation was chest discomfort. In the other three, chest discomfort was part of a more extensive stroke syndrome. The symptoms were described as ''burning,'' ''hot feeling,'' ''flashes,'' ''tightness,'' and ''cold.'' In three patients, an MRI or CT scan showed an infarct in the thalamus, corona radiata, or lateral medulla. Cardiac evaluation was negative in all but one patient who had single vessel percutaneous transluminal coronary angioplasty without resolution of sensory symptoms. Chest discomfort fluctuated but persisted for months or years after presentation. Conclusion: Chest discomfort mimicking cardiac ischemia may be a prominent sensory symptom in acute stroke.