Related Experiment Video
Updated: Dec 6, 2025
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Transient Cardiac Dysfunction in Cerebrovascular Accidents
Ahmed Elkhouly1, Rana A Tauseen2, Steven Hamilton1
1Internal Medicine, St. Francis Medical Center, Trenton, USA.
Insights
Electrocardiogram (EKG) changes, including T-wave inversions, can indicate acute cerebral injuries like stroke. This case highlights cerebral T-waves as a sign of neurological events, not always cardiac issues.
Area of Science:
- Neurology
- Cardiology
- Medical Imaging
Background:
- Acute cerebral injuries are linked to electrocardiogram (EKG) changes, including arrhythmias and T-wave abnormalities.
- Cerebral T-waves, characterized by deep, inverted T-waves in precordial leads, are a rare phenomenon associated with stroke.
Observation:
- A patient presented with acute pulmonary edema, T-wave inversions, and left ventricular dysfunction, initially mimicking acute coronary syndrome (ACS).
- Diagnostic workup revealed the cardiac symptoms were secondary to an underlying acute cerebral injury.
Findings:
- The patient's presentation of T-wave inversions and cardiac dysfunction was ultimately attributed to a cerebral event, not ACS.
- This case underscores the importance of considering neurological causes for seemingly cardiac symptoms.
Implications:
- Recognizing cerebral T-waves is crucial for accurate diagnosis and timely treatment of stroke.
- Autonomic dysfunction following cerebral injury can manifest as transient cardiac dysfunction, requiring a comprehensive diagnostic approach.
Abstract:
Acute cerebral injuries have been repeatedly correlated with sudden and different electrocardiogram (EKG) changes, such as cardiac arrhythmias, QT prolongation, and abnormal T-wave morphology. One rare phenomenon is "cerebral T-waves," which are T-waves observed in the context of stroke and described as transient, symmetric, and deeply inverted. Moreover, few studies linked acute cerebral injuries with transient cardiac dysfunction secondary to autonomic dysfunction. The classic cerebral T-waves are defined as a T-wave inversion of ≥5 mm depth in ≥4 contiguous precordial leads, and it is more commonly observed in the setting of acute ischemic stroke rather than hemorrhagic stroke. We present a patient who presented with acute pulmonary edema, T-wave inversions in the precordial leads, and left ventricular (LV) dysfunction initially suspicious for acute coronary syndrome (ACS). However, computer tomography of the brain performed on the third day of his hospital stay proved us wrong.
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:30Coronary Artery Disease III: Clinical Manifestations
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations