Cardiac disease reduces the long-term survival of stroke patients and increases the likelihood of intercurrent medical illness during the rehabilitation phase. It remains controversial whether heart disease negatively affects functional capabilities after stroke, but most studies agree that associated cardiac disease, especially congestive heart failure, adversely affects functional outcomes after stroke rehabilitation. Reliable clinical assessment of the presence and severity of heart disease in stroke patients may be hampered by mobility limitations, communication deficits, and other problems. Therefore, specialized diagnostic methods may be needed. The development and application of effective and consistent medical and rehabilitation guidelines for proper comprehensive care may enhance the likelihood of achieving favorable outcomes and of avoiding complications in patients with stroke.