Abstract
Aims and Objectives: The present study was undertaken to find out ECG abnormalities associated with acute stroke and relationship of these abnormalities in cerebrovascular accident with mortality and prognosis.
Method: The study consisted of total 100 cases with history and clinical manifestations suggestive of acute stroke and confirmed by CT head and admitted in medicine wards of hospital. ECG changes in various types of stroke were observed in all the cases and results were analyzed statistically.
Results: The ECG changes observed in patients with acute stroke were T Wave inversion in 28 (28%), LVH (12%), ST depression (10%), prolonged QTc in 10(10%) and U wave 2(2%) cases. Rhythm abnormalities commonly noticed were sinus tachycardia in 5 (5%) cases, sinus bradycardia in 4(4%), ventricular premature complexes in 3 (3%) and supraventricular tachycardia in 2 (2%) cases. T-wave inversion (27.58%) and ST segment depression (10.34%) were common ECG abnormalities in ischemic stroke whereas QTc prolongation (28.57%), LVH (16.66%) and T inversion (16.66%) in hemorrhagic stroke. The overall mortality rate was 40% with higher in stroke group with abnormal ECG than those with normal ECG. QTc prolongation had prognostic significance in predicting mortality in stroke patients. No correlation was found with ECG abnormalities with location of brain lesion
Conclusion: Different ECG changes are observed in acute stroke patients even in absence of primary cardiac disease and these ECG changes can be predictor of prognosis.
Keywords: ECG, Acute stroke, Cerebrovascular accident, Prognosis, CT head, intracranial lesion.
References
- Smith WS, English JD and Johnston SC. In: Longo DL, Fauci AS, Kasper DL, Hauser, Jameson JL, Loscalzo J, editors. Harrrison`s principles of internal medicine. 18th ed. New York: McGraw-Hill. 2011;370:3270.
- Ince B, Celik Y, Bingol H, Harmanci H, Denktas H. Electrocardiographic findings and prognosis inischemic stroke. Cerrahpasa J Med. 1998;29:70-4.
- Dimant J, Grob D, Electrocardiographic changes and myocardial damage in patients with acute cerebrovascular accidents, Stroke, 8, 1977,455.
- Croopp GJ, Manning GW, Electrocar-diographic changes stimulating myocardial ischemia and interactions associated with spontaneous intracranial haemorrhage, Circulation, 22, 1960, 25-38.
- Prosser J, Mac Gregor L, R Kennedy, D Hans- Christoph, Predictors of early cardiac morbidity and mortality after ischemic stroke, Stroke, 38, 2007, 2295-2302.
- Purushothaman S et al. Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents.J Nat Sci Bio Med 2014;5:434-6.
- Jain KK et al . ECG changes in patients of cerebrovascular diseases.Medpulse- Interna-tional Medical Journal. 2015; 2(4):256-25.
- Somasundaran A, Jayaraj et al. Electrocardiographic Changes In Acute Stroke Patients. Asian Journal of Science and Technology.2015;6: pp. 1595-1599.
- Kumar S, Sharma GD et al. A study of electrocardiogram changes in patients with acute stroke. Int J Res Med Sci. 2016;4(7):2930-2937.
- Channappa KC, Yogeesha KS et al. Electrocardiographic changes observed in hemorrhagic and ischemic cerebrovascular diseases. J. Evid. Based Med. Healthc 2016; 3(23), 1025-1028.
- Hasan A et al. A study on electrocardiographic findings in acute stroke, a case controlled study in tertiary hospital in Eastern India. Sudan Med Monit2016;11:13-7.
- Muhammad Rehan et al. Frequency of Various Electrocardiographic Changes in Patients with Acute Stroke. KJMS 2015;8(3).
- Kumar S. Jaikar B et al. Analysis of Electrocardiographic changes in Cerebrovascular Accidents. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS).2014;13(5):25-29.
- Ramteke SK, Tomar APS et al. Study of ECG and Echocardiographic abnormalities in stroke patients and its prognostic significance. Journal of Evolution of Medical and Dental Sciences 2014;3(11):2693-2698.
- Saxena P, Kumar L et al. Prognostic Importance of ST-T Changes in ECG in Acute Stroke. International Journal of Contemporary Medical Research 2016;3(7):1999-2001.
- Tiwari D, Gupta RK et al. ECG change in patients of stroke- what are they and what is their significance. International Journal of Applied Research 2015; 1(9): 701-703.
- Mashooq Ali Dasti et al. Acute ischemic stroke; electrocardiographic and echocardiographic findings in patients. (Potential source of cardiac emboli). Professional Med J2016;23(5):535-538..
- Shuster S. The electrocardiogram in subarachnoid haemorrhage. Br Heart J. 1960;22:316–20.
- Cropp GJ, Manning GW. Electrocardiographic changes simulating myocardial ischemia and infarction associated with spontaneous intracranial hemorrhage. Circulation. 1960;22:25–38.
- Hunt D, McRae C, Zapf P. Electrocardiographic and serum enzyme changes in subarachnoid hemorrhage. Am Heart J. 1969;77:479–88. 140.
Corresponding Author
Dr Milind Vyawahare*
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.