A stroke patient with an unusual electrocardiogram
Elena M Donald1, James A Reiffel1, Jose M Dizon1
1Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA.
Journal of Electrocardiology
|August 23, 2024
Summary
This case study highlights a rare instance of junctional bradycardia with dual atrioventricular node physiology in a stroke patient. The arrhythmia resolved with stroke recovery, suggesting a link between acute stroke and cardiac electrical disturbances.
Area of Science:
- Cardiology
- Neurology
- Electrophysiology
Background:
- Acute stroke can present with various neurological deficits.
- Cardiac arrhythmias are common in stroke patients and can be associated with adverse outcomes.
- Dual atrioventricular node physiology is a rare electrophysiological phenomenon.
Observation:
- A 70-year-old man with a history of atrial flutter presented with acute stroke symptoms.
- Physical examination revealed bradycardia (50 bpm) and right-sided facial droop with dysarthria.
- Admission electrocardiogram (ECG) demonstrated junctional bradycardia with retrograde dual atrioventricular node physiology.
Findings:
- The patient's bradycardia was attributed to parasympathetic sinus node slowing secondary to the acute stroke.
- During monitoring, the patient's sinus rhythm returned with chronotropic competence.
- No further arrhythmias were observed during the hospital admission.
Implications:
- This case suggests a potential association between acute stroke and transient cardiac electrical abnormalities, specifically dual AV node physiology.
- Understanding these associations is crucial for comprehensive stroke management and risk stratification.
- Further research may elucidate the mechanisms linking neurological events to cardiac electrophysiology.
Related Concept Videos
01:29Electrocardiogram
2.2K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
2.2K
01:28Disturbances in Heart Rhythm
922
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
922
01:28Electrocardiogram Fundamentals
550
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
550
01:24ECG Interpretation of Rhythms
600
An electrocardiogram (ECG)graphically represents the heart's electrical activity on ECG paper or a monitor.
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....
600
01:30Cardiac Action Potential
1.1K
Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
1.1K
01:30Pulse rhythm
775
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
775