Abstract

Cardiac abnormalities occur in 60 to 70 percent of patients after stroke. The most common disturbance include ECG abnormalities, cardiac arrhythmias, and myocardial injury and dysfunction distinguishing cardiac abnormalities directly caused by stroke. More importantly, cardiac disturbances are the most common cause of death in stroke accounting for up to 6 percent of unexpected death during the first month. The severity of the neurological injury is strongly associated with the presence of left ventricular dysfunction. Similarly, diastolic dysfunction is also common after SAH, is associated with the severity of the neurological injury, and maybe the cause of pulmonary edema seen in these patients. To study the incidence and pattern of ECG changes in a patient with cerebrovascular accidents To assess the relation of ECG changes in an acute cerebrovascular accident to the location of the cerebral lesion. Material and Methods: This is an observational study. A total of 50 patients were included in the study. The present study was conducted in a tertiary care hospital. The study was conducted at Sri Muthukumaran Medical College Hospital And Research Institute, Chikkarayapuram, Kundrathur Road, Near Mangadu, Chennai - 600 069. All patients admitted to the medical ward with acute cerebrovascular accidents who satisfy the inclusion criteria were enrolled in the study. All patients with acute cerebrovascular accidents were studied. They were assessed with serum electrolytes, X-ray and blood urea, and sugar 12 lead ECG was taken and monitored on the day of admission. CT scan was taken within 24-48 hrs. Patients were categorized based on the CT finding as cerebral infarction, cerebral haemorrhage , and subarachnoid haemorrhage . ECG was then interpreted with rate, rhythm, ST segment, QRS complex, T wave amplitude, and morphology, and the QT interval was calculated. QTC interval was calculated based on Bazetts formulae. 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.

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