Cardiac problems in patients with neurologic disease.

The cardiologist and internist can make a major contribution to the care of patients with neurologic disease, both in terms of treating patients with symptomatic cardiac involvement and reducing mortality. This article highlights the need to recognize ECG abnormalities that may represent purely neurologic disease as well as indicate cardiac pathology that may be part of the neurophysiologic disease process. The role of cardiac emboli in stroke and the essential role of anticoagulation in stroke prevention have been discussed. Additionally, the importance of emboli in relation to endocarditis and the essential role of anticoagulation for stroke prevention in patients with prosthetic valves have been emphasized. Finally, the cardiac manifestations of several neuromyopathic diseases have been indicated, and the importance of cardiac issues in patient management decisions has been shown. The interplay of cardiac and neurologic concerns demonstrates how a collaboration of neurologists and cardiologists can yield rewarding results in resolving some of the more difficult problems in clinical medicine.