title: ECG changes of cardiac origin in elderly patients with traumatic brain injury.
abstract: BACKGROUND
  Simultaneous electrocardiographic (ECG) changes are seen in hemorrhagic brain events even in the absence of associated myocardial infarction (MI). This study was designed to assess the role of ECG changes to predict true MI in patients with hemorrhagic brain trauma.
  
  
  METHODS
  Data of 153 patients with traumatic brain injury and concomitant ECG changes were recorded. Enzyme study was performed for the patients, and a cardiologist confirmed the diagnosis of MI.
  
  
  RESULTS
  Overall, 83 females and 70 males older than 50 years of age were enrolled in the study. The most common type of hemorrhagic brain event was subarachnoid hemorrhage, and the most common ECG change was an inverted T wave. MI was confirmed in 15 (9.8%) patients. Patients with intracranial hemorrhage had significantly (p= 0.023) higher rates of associated MI than other types of brain hemorrhages. ST segment elevation was found to have a positive predictive value of 71.4% in males and 25% in females in terms of diagnosing a true MI associated with hemorrhagic brain events.
  
  
  CONCLUSIONS
  Although simultaneous cardiac changes are seen after sympathetic over- activity in brain hemorrhages, regular ECG screening of elder patients with traumatic brain injury is suggested, particularly in patients with intracranial hemorrhages.
authors.affiliation: MD, Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. hashemianam@mums.ac.ir.
authors.forename: Amir Masoud
authors.initials: AM
authors.lastname: Hashemian
authors.affiliation: MD, Associate Professor of Emergency Medicine, Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran. ahmadik@mums.ac.ir.
authors.forename: Koorosh
authors.initials: K
authors.lastname: Ahmadi
authors.affiliation: MD, Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran. dr.alitaheriniya@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Taherinia
authors.affiliation: MD, Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. sharifimd@mums.ac.ir.
authors.forename: Mohamad Davood
authors.initials: MD
authors.lastname: Sharifi
authors.affiliation: MD, Assistant Professor of cardiology, Department of cardiology, Mashhad University of medical sciences, Mashhad, Iran. ramezanij@mums.ac.ir.
authors.forename: Javad
authors.initials: J
authors.lastname: Ramezani
authors.affiliation: MD, General Practitioner, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. s.b.jazayeri@gmail.com.
authors.forename: Seyed Behzad
authors.initials: SB
authors.lastname: Jazayeri
authors.affiliation: MD, Associate Professor of Epidemiology, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran Soheil.saadat@gmail.com.
authors.forename: Soheil
authors.initials: S
authors.lastname: Saadat
authors.affiliation: MD, Professor of Neurosurgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. v_rahimi@sina.tums.ac.ir.
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
keywords: Electrocardiography; Intracranial Hemorrhage; Myocardial Infarction; Positive Predictive Value; Subarachnoid Hemorrhage; Traumatic Brain Injury