| Checkboxes | Criteria | Points |
|---|---|---|
| Demographics | ||
| Female Sex | 2 | |
| Age 65-74 Years | 1 | |
| Age >=75 Years | 2 | |
| Stroke Phenotype | ||
| Ischemic stroke | 2 | |
| Hemorrhagic stroke | 2 | |
| NIHSS 6–14 (moderate) | 2 | |
| NIHSS ≥15 (severe) | 4 | |
| Neuroanatomy | ||
| Right insular involvement on imaging | 5 | |
| Any insular involvement (unspecified side) | 3 | |
| Anterior fossa ischemic location | 2 | |
| Physio "Trigger" Burden | ||
| Respiratory failure or Hemodynamic shock | 4 | |
| Severe hypertension or Sustained tachyarrhythmia | 2 | |
| ECG (first 6–12h) | ||
| ST depression or pathologic Q waves | 5 | |
| Prolonged QTc (sex-specific) | 2 | |
| T-wave inversion/flattening (new) | 2 | |
| Cardiac Biomarkers | ||
| High-sensitivity troponin above 99th %ile | 5 | |
| Dynamic troponin change ≥20% at 3–6h | 2 | |
| Echocardiogram | ||
| Reduced LVEF <50% or new systolic dysfunction | 4 | |
| Mid-ventricular WMA pattern | 5 | |
| Apical WMA (Takotsubo-like) | 3 | |
| Labs (first 24h) | ||
| Albumin <35 g/L | 3 | |
| Context | ||
| First-ever AIS with no prior heart disease | 4 | |
| Checkboxes | Criteria | Points |
|---|---|---|
| Cardiac Injury | ||
| hs-Troponin >5× URL or dynamic rise ≥50% | 4 | |
| ST depression/Q waves | 3 | |
| Arrhythmia Burden | ||
| Severe ventricular arrhythmia (VT/VF) | 5 | |
| AF/flutter with RVR or recurrent episodes | 3 | |
| Pump Function | ||
| LVEF <40% or cardiogenic pulmonary edema | 5 | |
| LVEF 40–49% | 3 | |
| Mid-ventricular WMA | 4 | |
| Systemic Stress | ||
| Ongoing respiratory failure or shock | 4 | |
| Host Factors | ||
| Albumin <35 g/L | 2 | |
| Age ≥75 | 2 | |
| Neuroanatomy | ||
| Right insular involvement | 2 | |