A STUDY OF ELECTROCARDIOGRAPHIC FINDINGS IN PATIENTS WITH ACUTE CVA

Abstract

Background - Electrocardiographic abnormalities are common in patients with acute CVA, the possible mechanism of which is the disturbances in autonomic regulation and excessive stimulation of sympathetic nervous system resulting in disordered repolarization process. Physicians are often confronted due to ECG abnormalities in acute CVA since it often mimick that of myocardial ischemia. The present study was undertaken with the objective to describe the frequency and pattern of common ECG abnormalities in CVA. Methodology - This is a retrospective case series study conducted among patients with acute stroke admitted to HSK hospital bagalkot during February 2020 - August 2020. A 12 lead ECG of cases fulfilling the inclusion and exclusion criteria of our study were evaluated for characters like P wave,PR segment, QRS,ST segment, Q wave etc. Sample size estimation was done using open epi Software version 2.3.1 Results - Among the 90 cases, 70% had abnormal ECG. Among cerebral infarction 61(67.7%) cases, ST segment depression was found in 21(34.4%), Qtc prolongation in 16(26.2%), T wave inversion in 13(21.3%) and wide QRS in 14(22.9%). Among cerebral hemorrhage 24(26.6%), prolonged QTc was found in 10(41.6%), T wave inversion in 9(37.5%), ST segment elevation in 6(25%) and tall T wave in 4(16.6%) patients. In SAH patients, ST segment elevation was found in 2(40%), tall T wave in 2(40%), and T wave inversion in 2(40%). Conclusion - Abnormal electrocardiographic findings are common in patients with acute cerebrovascular accidents even in the absence of electrolyte imbalance or known organic heart disease. ECG abnormalities like ST segment elevation, tall T wave, T wave inversion, and prolonged QTc were commoner in cerebral infarction than in cerebral hemorrahge whereas ST segment depression was predominantly found in patients with cerebral hemorrhage. Understanding that these abnormalities are associated with acute CVA is important to avoid erroneous judgment of assigning these patients as having cardiac dysfunction.