Dear Sir,The recent report on “electrocardiographic abnormalities in acute cerebrovascular events” is very interesting.[1] Togha et al., concluded that “Ischemia-like ECG changes and arrhythmias are frequently seen in strokepatients, even in those with no history or signs of primary heart disease, which support a central nervous system origin of these ECG abnormalities.[1]” The interesting question is why there is a high rate of concomitant abnormalities. Indeed, the pathophysiology of cardiovascular and cerebrovascular abnormalities usually starts from the thromboembolic disorders and this might be the possible clue for the possible high concurrence. Based on this work, it might imply that there is a need to investigate for possible cardiac disorder among any patients with cerebrovascular problem and there is also a need to perform complete neurological assessment for any patients with cardiovascular diseases. Last but not least, investigation for the underlying metabolic disorders (diabetes mellitus, dyslipidemic, etc.) which can be the starting points for unwanted vascular events should be done.