Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease
Mansoureh Togha1, Alireza Sharifpour, Haleh Ashraf
1Iranian Center of Neurological Research, Tehran, Iran.
Insights
Electrocardiogram (ECG) changes like T-wave abnormalities and arrhythmias are common after acute stroke, even without prior heart disease. These findings suggest a central nervous system origin for ECG abnormalities in stroke patients.
Area of Science:
- Cardiology
- Neurology
- Medical Diagnostics
Background:
- Electrocardiographic (ECG) changes are frequently observed following acute strokes.
- Stroke's cardiovascular effects are influenced by existing cardiac conditions, stroke type, and lesion location.
Purpose of the Study:
- To identify patterns of ECG changes across different pathophysiologic stroke categories.
- To investigate the relationship between specific ECG abnormalities and stroke lesion location.
- To analyze ECG changes in stroke patients with and without pre-existing cardiovascular disease.
Main Methods:
- Analysis of electrocardiographic records from 361 patients diagnosed with acute stroke.
- Assessment of the frequency of various ECG abnormalities within different stroke categories.
Main Results:
- The most prevalent ECG abnormalities in stroke patients were T-wave abnormalities (39.9%), prolonged QTc interval (32.4%), and arrhythmias (27.1%).
- Patients without primary cardiac disease showed similar trends: T-wave abnormalities (28.9%), prolonged QTc interval (30.7%), and arrhythmias (16.2%).
- Specific findings included more T-wave abnormalities with posterior fossa bleeds and increased rhythm disturbances in anterior fossa ischemic lesions.
Conclusions:
- Ischemia-like ECG changes and arrhythmias are common in stroke patients, supporting a central nervous system origin.
- These ECG abnormalities can occur even in individuals without a history of heart disease.
- Further research is needed to fully understand the complex brain-heart interactions in stroke.
Objectives:
Electrocardiographic (ECG) changes are reported frequently after acute strokes. It seems that cardiovascular effects of strokes are modulated by concomitant or pre-existent cardiac diseases, and are also related to the type of cerebrovascular disease and its localization. We aimed to determine the pattern of ECG changes associated with pathophysiologic categories of acute stroke among patients with/without cardiovascular disease and to determine if specific ECG changes are related to the location of the lesion.
Materials And Methods:
The electrocardiographic records of 361 patients with acute stroke were studied to assess the relative frequencies of ECG abnormalities among the pathophysiologic categories of stroke.
Results:
In the present study, the most common ECG abnormalities associated with stroke were T-wave abnormalities, prolonged QTc interval and arrhythmias, which were respectively found in 39.9%, 32.4%, and 27.1% of the stroke patients and 28.9%, 30.7%, and 16.2 of the patients with no primary cardiac disease. We observed that other ECG changes comprising pathologic Q- wave, ST-segment depression, ST-segment elevation, and prominent U wave may also occur in selected or non-selected stroke patients; thereby simulate an acute myocardial injury. We observed an increased number of patients with abnormal T-wave and posterior fossa bleedings and more rhythm disturbances for ischemic lesions, localized in the anterior fossa.
Conclusion:
Ischemia-like ECG changes and arrhythmias are frequently seen in stroke patients, even in those with no history or signs of primary heart disease, which support a central nervous system origin of these ECG abnormalities. Further study is necessary to better define the brain-heart interaction.
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