Electocardiographic changes in acute cerebrovascular accidents-a tertiary centre experience in South India

Abstract

Cerebrovascular accident plays an important role in the morbidity and mortality of adults posing serious medical, socio-economic and rehabilitation problems. Electrocardiographic abnormalities have been known to occur in the context of neurological disease. The current study is an observational study aimed at elucidating the relation between cerebrovascular accident and ECG. Objectives: To determine the frequency of ECG changes in cerebrovascular accident and to determine the variations in ECG manifestations and mortality in different types of stroke. Materials and Methods: 100 patients of acute stroke were considered. ECG was recorded in these patients within 24 hours of admission. Follow up of admitted patients was done to know the prognosis. Results: ECG abnormalities noted among cerebral ischemic patients were presence of T Wave inversion (34.48%) and ST segment depression (32.76%) followed by QTc Prolongation (29.31%) and presence of U waves (27.59%). In cases of haemorrhagic Stroke, T wave inversion (33.33%) and arrhythmias (33.33%) were followed by U waves (30.95%) and ST segment depression (23.81%). Mortality was higher in patients with ST-T changes in ischemic group (66.66%) and in patients with positive U waves (60%) in haemorrhagic group. Studying ECG changes will provide insight in prognosis and management of stroke patients and may alter their management in coming future. Conclusion: ECG changes occurred very commonly in acute stroke. The changes are thought to be independent of the nature of stroke. It was noted that ST and T inversion being common in ischemic while T inversions and arrhythmias common in haemorrhagic CVA. It was also noted that the mortality was higher in patients with abnormal ECG following an acute Cerebrovascular event.