In a prospective multicenter study, use of a formal screen- ing protocol for dysphagia (eg, water swallow test) for all patients admitted with ischemic stroke was associated with a significantly reduced risk of pneumonia compared with no The pneu- monia rate of sites with a formal dysphagia screen was 2.4% versus 5.4% of those without a screen, a 3% absolute risk reduction. Serious cardiac events and cardiac death after stroke may be caused by acute myocardial infarction (MI), heart failure, ventricular arrhythmias including ventricular tachycardia/ fibrillation, and cardiac arrest. Concurrent stroke and MI are not uncommon. Recent data from the prospective Austrian Stroke Unit Registry, which included 4984 ICH patients, found that 0.3% of patients had an MI over a median duration These patients not only experienced higher in- hospital mortality but also had greater complications, includ- ing pneumonia and progressive stroke. History of prior MI and severity of deficits on admission are associated with the occurrence of MI. In a meta-analysis of 65996 stroke patients with a mean follow-up of 3.5 years,176 the annual risk of MI was 2.2 %. For ICH patients, an elevated troponin level >0.4 ng/mL was found in 15% within 24 hours of admission and was associated with increased in-hospital mortality.21 In another study of 49 patients with supratentorial ICH, exclud- ing those who died within 12 hours or were moribund, 20% had elevated troponin levels, although this was not associated Heart failure can occur as the result of myocardial isch- emia, infarction, stress-induced cardiomyopathy, or uncon- trolled hypertension in the setting of acute ICH. 