[Electrocardiographic anomalies in subarachnoid hemorrhage]

An electrocardiographic study was undertaken in 100 patients with subarachnoid haemorrhage to try and establish a relationship between the clinical state of the patient and the ECG abnormalities. Cerebral angiography was performed in 95 cases showing 1 or more aneurysms in 68 cases and an angioma in 6 cases. Twenty one patients had no cerebrovascular abnormality. Routine ECGs were recorded on admission and were abnormal (Lipman and Massie's criteria) in 80 p. 100 of cases. The commonest changes were T-wave inversion (34 cases), bradycardia (32 cases), abnormal U-waves (28 cases) and prolongation of the Q-T interval (21 cases). Only 2 patients had giant T waves of normal polarity. Intraventricular conduction defects were more common (12 cases) than atrioventricular block (3 cases). Ten patients had sinus tachycardia and ventricular extrasystoles were observed in 5 cases. The patients were divided into two groups according to severity of their clinical state: Group A (52 patients) without changes in the level of consciousness, and Group B (48 patients) with disturbed levels of consciousness. The incidence of bradycardia and T-wave inversion in the two groups was compared by the Chi-squared test. Bradycardia was commoner than T-wave inversion in Group A (52 p. 100 and 19 p. 100 respectively). This finding was the contrary to what was observed in Group B where 10 p. 100 of patients had bradycardia (p less than 0,0005) and 50 p. 100 had T-wave inversion (p less than 0,005). The ECG changes were of prognostic value. The survival rate in patients with T-wave inversions was 85,7 p. 100 (p less than 0,001). The presence and site of the cerebrovascular abnormalities were not related to the ECG changes and no correlations were found between electrolyte changes and the ECG appearances.(ABSTRACT TRUNCATED AT 250 WORDS)