Suja Purushothaman1, Deepalaxmi Salmani2, Kaleramma Gopalakrishna Prarthana3, Srinidhi Muddanna Gundappa Bandelkar4, Sarah Varghese5
1 Department of Physiology, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode, Kerala, India
2 Department of Anatomy, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode, Kerala, India
3 Department of Physiology, Srinivasa Instituite of Medical Sciences and Research Centre, Mangalore, India
4 Department of Physiology, A.J.Institute of Medical Sciences, Mangalore, Karnataka, India
5 Department of Physiology, Pondicherry Institute of Medical Sciences, Pondicherry, India
Background: Its being long recognized about the highly debilitating and destructive nature of cerebrovascular accidents (CVAs). Around the world CVAs has posed as a major factor in medical morbidity and mortality. It has thrown up challenges with regards to their medical management and also towards posttreatment rehabilitation. It is well-known that neurologic disorder contributes variously towards varied electrocardiogram (ECG) changes and stroke is no exception. Objective: To study the ECG changes and its relation to mortality in cases of CVA. Materials and Methods: A total of 100 patients with acute stroke were enrolled in the study. All the 100 patients underwent ECG recording within first 24 h of admission. The patients were divided into ischemic and hemorrhagic group depending on the nature of lesion. Results: Out of 100 cases, 58 were ischemic and 42 were hemorrhagic. The ECG changes were noted in 78 patients. Among the ischemic group, the changes noted in the ECG were: T wave inversion (34.48%), ST segment depression (32.75%), QTc prolongation (29.31%), and presence of U waves (27.58%). In cases of hemorrhagic stroke, it was: T wave inversion (33.33%), arrhythmias (33.33%), U waves (30.95%), and ST segment depression (23.80%). Mortality was higher in patients with ST-T changes in ischemic group (66.66%) and in patients with positive U waves (60%) in hemorrhagic group. Conclusion: In acute stroke patients, changes in ECG were commonly seen. The changes varied from T-wave inversion to ST segment depression in ischemic stroke. In hemorrhagic stroke it consisted of T wave inversion and arrhythmias. Overall mortality was high in cases of hemorrhagic compared to ischemic group.
Keywords: Cerebrovascular accident, ECG, stroke