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Cardiac function in aneurysmal subarachnoid haemorrhage: a study of electrocardiographic and echocardiographic
K R Davies1, A W Gelb, P H Manninen
1Department of Anaesthesia, University Hospital, London, Ontario, Canada.
Insights
Electrocardiographic (ECG) changes after subarachnoid hemorrhage (SAH) do not accurately predict cardiac function. Myocardial dysfunction is more closely linked to the severity of neurological impairment.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Subarachnoid hemorrhage (SAH) frequently causes electrocardiographic (ECG) changes.
- The functional significance of these ECG changes on cardiac function remains unclear.
- Echocardiography is a key tool for assessing cardiac function.
Observation:
- Forty-five patients with intracranial aneurysms underwent ECG and echocardiography.
- Most patients showed no significant cardiac abnormalities on echocardiography.
- Only four patients had wall motion abnormalities, correlating with severe neurological dysfunction, not specific ECG changes.
Findings:
- Electrocardiographic changes, including deep inverted T waves, were not reliable indicators of myocardial dysfunction post-SAH.
- Patients with severe neurological deficits exhibited cardiac issues, irrespective of typical ECG patterns.
- Echocardiographic assessment revealed normal cardiac function in most patients despite ECG abnormalities.
Implications:
- The study suggests ECG is an unreliable predictor of myocardial function following SAH.
- Cardiac dysfunction post-SAH is more accurately associated with neurological severity.
- Further research should focus on the relationship between neurological status and cardiac outcomes in SAH patients.
Abstract:
Electrocardiographic (ECG) changes are reported frequently after subarachnoid haemorrhage (SAH). The aim of this study was to investigate the functional significance of ECG changes by echocardiographic assessment of cardiac function. Forty-five patients with intracranial aneurysms were studied. All patients had a 12-lead ECG and a two-dimensional echocardiogram. After patients with an history of chronic cardiac disease (n = 4) were excluded, only four patients were found to have wall motion abnormalities. These patients had only minor ECG abnormalities, but severe neurological dysfunction. Conversely, patients with other ECG abnormalities including the deep inverted T waves associated usually with SAH, had normal echocardiograms. We conclude that the ECG is not an accurate predictor of myocardial function after SAH and that myocardial dysfunction is related more closely to severity of neurological condition.