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Published on: June 21, 2019
ECG changes of cardiac origin in elderly patients with traumatic brain injury
Amir Masoud Hashemian1, Koorosh Ahmadi2, Ali Taherinia3
1MD, Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. hashemianam@mums.ac.ir.
Insights
Electrocardiogram (ECG) changes can indicate myocardial infarction (MI) in patients with brain hemorrhages. ST segment elevation on ECG is a key indicator for diagnosing true MI in these cases, especially in older males.
Area of Science:
- Neurology
- Cardiology
- Trauma Care
Background:
- Electrocardiographic (ECG) changes frequently occur during hemorrhagic brain events without concurrent myocardial infarction (MI).
- The relationship between ECG abnormalities and true MI in patients with traumatic brain injury (TBI) requires further investigation.
Purpose of the Study:
- To evaluate the predictive value of ECG changes for diagnosing true MI in patients experiencing hemorrhagic brain trauma.
- To identify specific ECG patterns indicative of MI in the context of TBI.
Main Methods:
- A cohort of 153 patients with TBI and concurrent ECG changes were analyzed.
- Enzyme studies and cardiological assessment were utilized to confirm MI diagnoses.
- Patient data, including demographics and hemorrhage type, were recorded.
Main Results:
- Myocardial infarction (MI) was confirmed in 9.8% of patients.
- Intracranial hemorrhage was associated with significantly higher rates of MI (p=0.023) compared to other brain hemorrhages.
- ST segment elevation demonstrated a 71.4% positive predictive value for MI in males and 25% in females.
Conclusions:
- While cardiac changes can result from sympathetic overactivity in brain hemorrhages, regular ECG screening is recommended for elderly patients with TBI.
- Particular attention should be given to patients with intracranial hemorrhages due to their higher association with MI.
Background:
Simultaneous electrocardiographic (ECG) changes are seen in hemorrhagic brain events even in the absence of associated myocardial infarction (MI). This study was designed to assess the role of ECG changes to predict true MI in patients with hemorrhagic brain trauma.
Methods:
Data of 153 patients with traumatic brain injury and concomitant ECG changes were recorded. Enzyme study was performed for the patients, and a cardiologist confirmed the diagnosis of MI.
Results:
Overall, 83 females and 70 males older than 50 years of age were enrolled in the study. The most common type of hemorrhagic brain event was subarachnoid hemorrhage, and the most common ECG change was an inverted T wave. MI was confirmed in 15 (9.8%) patients. Patients with intracranial hemorrhage had significantly (p= 0.023) higher rates of associated MI than other types of brain hemorrhages. ST segment elevation was found to have a positive predictive value of 71.4% in males and 25% in females in terms of diagnosing a true MI associated with hemorrhagic brain events.
Conclusion:
Although simultaneous cardiac changes are seen after sympathetic over- activity in brain hemorrhages, regular ECG screening of elder patients with traumatic brain injury is suggested, particularly in patients with intracranial hemorrhages.
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