Electrocardiographic Changes and Their Prognostic Effect in Patients with Acute Ischemic Stroke without Cardiac Etiology

Abstract

ÖzOriginal Article / Özgün Araştırma Amaç: Akut iskemik inme, EKG sonuçları ve kardiyak enzim düzeyleri üzerinde etkili olmakla birlikte mekanizması açık bir şekilde belirlenememiştir. Amacımız akut iskemik inmede EKG ve kardiyak enzim değişikliklerini incelemek ve bu değişiklikler ile inme lokalizasyonu ve prognoz arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler:Çalışma 241 akut iskemik inme hastalarını içermektedir., Çalışmaya kardiak aritmi ve inme öyküsü olmayanlar ile EKG ritmi ve süresini etkileyen ilaç kullanımı, akut veya kronik MI öyküsü ve elektrolit dengesizliği olmayanlar dahil edildi. İnme vasküler risk faktörleri, CK-MB ve TnI düzeyleri,EKG sonuçları incelendi. Bulgular: Yaş ortalamaları benzer olan 123 hastada sağ hemisfer enfarktı ve 118 hastada sol hemisfer enfarktı vardı. HT sağ hemisfer infarktlarında daha sıktı (p = 0.013). En sık karşılaşılan EKG anormallikleri; QTc uzaması (% 31), ST depresyonu (% 24)'ydı. Sağ hemisferik ve serebellar enfarktı olan hastalarda CK-MB ve TnI düzeyleri anlamlı olarak daha yüksekti. NIHSS skorları ve enfarkt hacimleri sol hemisferde ve serebellar enfarktlarda daha yüksekti (p <0.05). QRS süreleri serebellar enfarktlarda daha uzun saptandı (p = 0.05).Sonuç: Akut iskemik inmeli hastalarda 24 saat içinde en sık görülen EKG anormalliği QTc uzamasıydı. Sağ hemisfer ve serebellar enfarktlı hastalarda CK-MB ve TnI düzeyleri belirgin yüksek bulundu.vAkut iskemik inme, EkG değişiklikleri, TnI düzeyleri, inme prognozu, serebellar enfarkt Objective: Acute ischemic stroke has effect on ECG results and cardiac enzyme levels, but its mechanism has not been clearly established. Our aim is to research ECG and cardiac enzyme changes in acute ischemic stroke and to investigate association between these changes and stroke localizations and prognosis. Materials and Methods:The study included 241 acute ischemic stroke patients. Patients without cardiac arrhythmia, history of previous stroke, use of drugs affecting the pattern and duration of ECG rhythm and without acute or chronic MI history and electrolyte imbalance were included. The vascular risk factors for stroke, CK-MB and TnI levels, ECG results were examined.Results: 123 patients had right hemisphere infarcts and 118 patients had left hemisphere infarcts with same mean ages. HT was more prevalent in right hemisphere infarcts (p=0.013). The most common ECG abnormalities were; QTc extension (31%) and ST depression (24%). CK-MB and TnI levels were significantly higher in patients with right hemispheric and cerebellar infarcts. QRS durations were longer in cerebellar infarcts (p=0.05). Conclusions:The most common ECG abnormality was QTc extension in acute ischemic stroke patients within 24 hours. CK-MB and TnI levels were higher in patients with right hemisphere and prominently cerebellar infarcts.

ECG Evaluation in Patients with Pneumothorax Admitted to the Emergency Department: A Three years Analysis

“…Acute chest pain conditions have a quite common symptoms and ECG is one of the most important diagnostic tool used in the differential diagnosis of these disorders (2). Many reasons, such as coronary artery diseases, pericardial diseases, ischemic stroke, electrolyte disturbances, and intoxications, can present with specific or nonspecific findings on ECG (16)(17)(18)(19)(20). Clinical conditions that decrease venous return to the thoracic cavity, disrupt perfusion, and increase systemic vascular resistance cause ECG changes.…”

Evaluation of ECG Features for the Classification of Post-Stroke Survivors with a Diagnostic Approach

“…The prevalence of ECG changes have a significant relationship with aging [49]; additionally, the ECG abnormalities are regularly seen in stroke patients [50,51]. Many studies reported that the most common ECG abnormalities associated with acute stroke are arrhythmia, prolonged QTc and T wave and U wave abnormalities [19,[52][53][54][55]. Accordingly, we noticed the prolonged QTc in the stroke group, including both male and female subjects, with the overall mean value of the QTc greater than 450 milliseconds.…”