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A study of electrocardiographic changes in acute cerebrovascular accidents

Srikanth Tandur, Suraj Sundaragiri.

Abstract
Background: Cardiac abnormalities occur in majority of patients after cerebrovascular accidents, accounting for unexpected deaths during the first month. The most common disturbances include electrocardiogram (ECG) abnormalities, cardiac arrhythmias, and myocardial injury and dysfunction.

Objectives: The present study aims to determine the electrocardiographic changes observed in different types of stroke, their prevalence, and to establish the prognostic significance of the ECG changes.

Material and Methods: This prospective study was carried out in a superspeciality hospital during 2 years which comprised of 100 patients. Patients were categorized based on computerized tomography findings into cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage. ECG changes are interpreted with rate, rhythm, and abnormalities and conclusions were derived.

Results: Stroke was most common in 5th and 6th decade. Cerebral infarction formed the largest group. Males had higher preponderance. Hypertension was the most common risk factor. In total, 74% had electrocardiographic abnormality. ECG changes are more common among cerebral hemorrhage and subarachnoid hemorrhage. Most common ECG abnormality was prolonged QTc interval. Overall immediate mortality was 23%. It was high in cerebral hemorrhage. Morality was high in patients with abnormal ECG, mostly with prolonged QTc and with T-wave inversion.

Conclusion: Patients with cerebrovascular accidents often have abnormal ECG in the absence of known organic heart disease or electrolyte imbalance. These ECG changes are more common in hemorrhagic than ischemic stroke. The mortality in these patients did not relate to the ECG changes seen but was dependent on the type of cerebrovascular accident and the level of consciousness on admission.

Key words: Cerebrovascular accidents; electrocardiographic changes; mortality


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