{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:27:20Z","timestamp":1757701640088,"version":"3.40.5"},"reference-count":8,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,8,17]],"date-time":"2020-08-17T00:00:00Z","timestamp":1597622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>\u2018Stroke chameleons\u2019 refer to a group of syndromes that initially are not diagnosed as cerebrovascular events but are then found to represent stroke. The objective of this study was to report on acute ischaemic stroke (AIS) patients with chest or epigastric pain of central origin, clinically resembling an acute coronary syndrome (ACS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective list was kept of AIS patients admitted to our institution between 2002 and 2014 with stroke symptoms appearing as an ACS on first clinical evaluation. For each identified patient, clinical and radiological features, delay to correct diagnosis, stroke etiology and 3\u2010month functional outcome were reviewed. Data were mainly extracted from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five AIS patients presenting mainly with chest or epigastric pain leading to a wrong diagnosis of ACS were identified. Cardiac evaluation showed minor electrocardiogram changes in two patients and isolated troponin elevation in one, subsequently shown to be of non\u2010coronary origin. The correct diagnosis of AIS was made only between 1\u00a0h and 72\u00a0h after hospital arrival. Four patients presented a vertebrobasilar stroke. None of the patients received acute stroke revascularization therapy despite two of them being in the time window for such treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acute ischaemic stroke presentation can infrequently resemble an ACS. In cases of negative cardiac work\u2010up, a central origin of chest pain should be considered, especially in the presence of subtle other neurological symptoms or signs. Appropriate diagnosis of stroke could avoid treatment delays and improve outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14457","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T04:00:34Z","timestamp":1596168034000},"page":"2312-2317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Stroke chameleons: acute central pain mimicking acute coronary syndrome"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1413-0343","authenticated-orcid":false,"given":"L.","family":"Rebord\u00e3o","sequence":"first","affiliation":[{"name":"Stroke Center Department of Neurology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland"},{"name":"Department of Neurology Hospital Professor Doutor Fernando Fonseca Amadora Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1825-1874","authenticated-orcid":false,"given":"S.","family":"Nannoni","sequence":"additional","affiliation":[{"name":"Stroke Center Department of Neurology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4429-2714","authenticated-orcid":false,"given":"D.","family":"Strambo","sequence":"additional","affiliation":[{"name":"Stroke Center Department of Neurology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4954-7579","authenticated-orcid":false,"given":"P.","family":"Michel","sequence":"additional","affiliation":[{"name":"Stroke Center Department of Neurology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001830"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000471929"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-017-0727-0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.2.548"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awv389"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.49.1.120"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.07.015"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr236"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fene.14457","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.14457","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.14457","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.14457","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T07:58:08Z","timestamp":1693814288000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.14457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,17]]},"references-count":8,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/ene.14457"],"URL":"https:\/\/doi.org\/10.1111\/ene.14457","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"type":"print","value":"1351-5101"},{"type":"electronic","value":"1468-1331"}],"subject":[],"published":{"date-parts":[[2020,8,17]]},"assertion":[{"value":"2020-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}