title: Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Physiology, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode, Kerala, India.
authors.forename: Suja
authors.initials: S
authors.lastname: Purushothaman
authors.affiliation: Department of Anatomy, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode, Kerala, India.
authors.forename: Deepalaxmi
authors.initials: D
authors.lastname: Salmani
authors.affiliation: Department of Physiology, Srinivasa Instituite of Medical Sciences and Research Centre, Mangalore, India.
authors.forename: Kaleramma Gopalakrishna
authors.initials: KG
authors.lastname: Prarthana
authors.affiliation: Department of Physiology, A.J.Institute of Medical Sciences, Mangalore, Karnataka, India.
authors.forename: Srinidhi Muddanna Gundappa
authors.initials: SM
authors.lastname: Bandelkar
authors.affiliation: Department of Physiology, Pondicherry Institute of Medical Sciences, Pondicherry, India.
authors.forename: Sarah
authors.initials: S
authors.lastname: Varghese
keywords: Cerebrovascular accident; ECG; stroke
references.citation: Stroke. 1979 May-Jun;10(3):253-9
references.pmid: 462510
references.citation: Stroke. 1977 Jul-Aug;8(4):448-55
references.pmid: 898240
references.citation: Neurol India. 2003 Dec;51(4):500-2
references.pmid: 14742932
references.citation: MEDICC Rev. 2010 Jul;12(3):20-6
references.pmid: 20697334
references.citation: Clin Auton Res. 2006 Feb;16(1):6-11
references.pmid: 16477489
references.citation: J Natl Med Assoc. 2006 Nov;98(11):1758-62
references.pmid: 17128684
references.citation: Neuroepidemiology. 2001 Aug;20(3):208-11
references.pmid: 11490168
references.citation: Indian J Med Res. 2009 Oct;130(4):396-403
references.pmid: 19942742
references.citation: Indian J Community Med. 2011 Jan;36(1):62-5
references.pmid: 21687386
references.citation: JAMA. 2010 Jun 9;303(22):2312
references.pmid: 20530787
references.citation: Stroke. 1974 Nov-Dec;5(6):775-80
references.pmid: 4432256