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Year : 2016  |  Volume : 11  |  Issue : 1  |  Page : 13-17

A study on the electrocardiographic findings in acute stroke, a case controlled study in a tertiary hospital in Eastern India

Department of Internal Medicine, IPGMER, Kolkata, West Bengal, India

Correspondence Address:
Sudipta Saha
Department of Internal Medicine, 1/20 M M, Ghosh Road, Kolkata - 700 074, West Bengal
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DOI: 10.4103/1858-5000.178507

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Context: In cerebrovascular accident (CVA) patients, electrocardiogram (ECG) changes may or may not be due to underlying cardiac illness. Aims: This study was done on CVA patients without underlying cardiac illness and diabetes, to evaluate the incidence and patterns of ECG changes in acute stroke. Settings and Design: Prospective nonrandomized case-control study in a tertiary hospital. Subjects and Methods: Ninety-seven CVA patients as case and 97 patients' age and sex matched, attending preanasthetic check-up without cardiac illness and diabetes were taken as control. ECG computed tomography brain, magnetic resonance imaging brain (in inconclusive situations) were done. Statistical Analysis Used: Chi-square test and Levine test using appropriate software IBM SPSS Version 22. Results: Among 97 CVA subjects, 80 had hemorrhage and 17 had infarcts. 55 lesions were situated in the right hemisphere and 42 in the left hemisphere. ECG changes were present in 89.6% patients (87 of 97). Among control 22.6% (22 of 97) had new ECG changes (P < 0.01). The most common ECG changes were prolonged QT c interval (78/97) 80.4%, increased QT c dispersion (QT cD) (66/97) 71%, and ST-T changes (16/97) 16.5%. Hemorrhagic strokes had more QT c prolongation (71/80) (81%) than ischemic CVA (7/17) (41%) (P < 0.001) QT cD was more with hemorrhage (63/80 = 79%) than with ischemia (6/17 = 35.3%) (P < 0.001) QT cD increase had increased mortality (29/69 = 42%) than with no QT cD increase (1/28 = 3.5%) (P < 0.001). Ischemic CVA had more ST-T changes (8/17 = 47%) than hemorrhage (8/80 = 10%) (P < 0.01). Conclusions: This study showed increased incidence of ECG changes following CVA. QT c and QT cD prolongation were more in hemorrhagic CVA while ST-T changes were more in ischemic CVA. Increased QT cD were associated with increased short-term mortality.

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