Abstract
Introduction
Ischemic stroke specifically refers to a central nervous system infarction that is accompanied by overt symptoms.1 Ischemic stroke is the most common type of stroke. Electrocardiographic (ECG) changes are frequently observed in ischemic stroke, and they are noticed gradually by clinicians. ECG changes often occur 12 to 48 hours after illness onset, and are transient, lasting for no more than 1 week. Nearly every type of ECG change, including cardiac arrhythmias, such as ventricular premature beats (VPB) or supraventricular ectopic beats, ventricular tachycardia (VT) and atrial flutter (AFL)/ fibrillation (AF), and repolarization abnormalities (ST-segment changes, QT interval prolongation and increased QT interval dispersion) have been described in stroke patients.2
QTc interval on ECG, is calculated from the beginning of Q wave to end of T wave. It measures the duration of both cardiac depolarization and repolarization. Prolonged QTc interval may result from either a genetic or acquired conditions (3).
References
- Sacco RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44: 2064.
- Samuels M. Cardiopulmonary aspects of acute neurologic diseases. NeurolIntens Care 1993.
- Heller SR. Abnormalities of the electrocardiogram during hypoglycaemia: the cause of the dead in bed syndrome? International journal of clinical practice Supplement. 2002(129):27-32.
- Malik M, Hnatkova K, Schmidt A, Smetana P. Accurately measured and properly heart-rate corrected QTc intervals show little daytime variability. Heart rhythm.2008;5(10):1424-31.
- Daniele O, Caravaglios G, Fierro B, et al. Stroke and cardiac arrhythmias. J Stroke Cerebrovasc Dis 2002; 11: 28–33.
- Khan IA. Long QT syndrome: Diagnosis and management. Am Heart J. 2002;143:7–14.
- Roden DM, Viswanathan PC. Genetics of acquired long QT syndrome. J Clin Invest. 2005;115:2025–32.
- Kallergis EM, Goudis CA, Simantirakis EN, Kochiadakis GE, Vardas PE. Mechanisms, risk factors, and management of acquired long QT syndrome: A comprehensive review. Scientific World Journal. 2012;2012:212178
- Kannankeril PJ, Roden DM. Drug-induced long QT and torsade de pointes: Recent advances. Curr Opin Cardiol. 2007;22:39–43.
- Yap YG, Camm AJ. Drug induced QT prolongation and torsades de pointes. Heart. 2003;89:1363–72.
- Birda CL, Kumar S, Bhalla A, Sharma N, Kumari S. Prevalence and prognostic significance of prolonged QTc interval in emergency medical patients: A prospective observational study. International journal of critical illness and injury science. 2018 Jan;8(1):28.
- Pickham D, Helfenbein E, Shinn JA, Chan G, Funk M, Weinacker A, et al. High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: Results of the QT in practice (QTIP) study. Crit Care Med. 2012;40:394–9.
- Pasquier M, Pantet O, Hugli O, Pruvot E, Buclin T, Waeber G, et al. Prevalence and determinants of QT interval prolongation in medical inpatients. Intern Med J. 2012;42:933–40.
- Stanojević M, Stankov S. Electrocardiographic changes in patients with chronic anemia. Srp Arh Celok Lek. 1998;126:461–6.
- Seftchick MW, Adler PH, Hsieh M, Wolfson AB, Chan ST, Webster BW, et al. The prevalence and factors associated with QTc prolongation among emergency department patients. Ann Emerg Med. 2009;54:763–8.
- Moyssakis I, Pantazopoulos N, Hallaq Y, et al. Prevalence of ST-segment depression, ventricular arrhythmias, and heart rate variability in patients with acute ischemic stroke. In: Scientific Forum on Quality of Care and Outcomes Research in 2002, pp.893–894.
- Perron AD and Brady WJ. Electrocardiographic manifestations of CNS events. Am J Emerg Med 2000; 18: 715–720.
Corresponding Author
Dr Kishore V
MBBS, (MD) General Medicine, Post Graduate
DOI: https://dx.doi.org/10.18535/jmscr/v8i11.101
