Electrocardiographic changes in cerebrovascular hemorrhage

Yamour, B.; Sridharan, Marandapalli R.; Rice, John F.; Flowers, Nancy C.

doi:10.1016/0002-8703(80)90343-9

Cited by 134 publications

(48 citation statements)

References 22 publications

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“…12 These data suggest that there are differential cerebral effects on autonomic function that depend on the side of the cerebrum. [13][14][15] Results of human insular cortex stimulation suggest rightsided dominance in sympathetic cardiovascular effects and left-sided dominance in parasympathetic effects. 2 In addition, animal experimentation using a rat model with middle cerebral artery occlusion, which results in a consistent lesion of brain including the insular cortex, directly addresses the role of lateralization of brain hemisphere, the site of cerebral infarction, and the effect of age on the ECG perturbations that develop after stroke.…”

Section: Discussionmentioning

confidence: 99%

Right Sylvian Fissure Subarachnoid Hemorrhage Has Electrocardiographic Consequences

Hirashima

Takashima

Matsumura

et al. 2001

Stroke

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Background and Purpose-Abnormal ECG changes are frequently observed in patients with subarachnoid hemorrhage (SAH). Recently, evidence has been obtained that right insular cortex mediates sympathetic cardiovascular effects. We therefore assessed the laterality and location of SAH dominance in inducing cardiovascular changes as measured by ECG, blood pressure, and heart rate. Methods-After exclusion of 11 SAH patients who died within 1 month after onset, we studied 118 consecutive patients.Data were obtained from records of blood pressure and pulse on admission. Abnormal ECG changes were determined from ECGs on admission and almost 1 month later. From brain CT scans performed immediately after admission, the amount of SAH in each of the 8 cisterns and fissures was measured semiquantitatively. Results-Twenty-six patients had abnormal changes on admission ECG, while 92 patients did not. Systolic blood pressure, diastolic blood pressure, and the amounts of blood in the left ambient cistern, left suprasellar cistern, quadrigeminal cistern, right ambient cistern, right suprasellar cistern, right sylvian fissure, and the set of all cisterns were significantly greater in the group with ECG change than in the group without ECG change. Multivariate logistic regression analysis with stepwise method indicated that systolic blood pressure Ͼ160 mm Hg (Pϭ0.0006) and the amounts of SAH in the quadrigeminal cistern (Pϭ0.022) and right sylvian fissure (Pϭ0.0019) were independently associated with abnormal ECG change. Conclusions-Cardiac

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Section: Discussionmentioning

confidence: 99%

Right Sylvian Fissure Subarachnoid Hemorrhage Has Electrocardiographic Consequences

Hirashima

Takashima

Matsumura

et al. 2001

Stroke

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“…The observation of prolonged Q-Tc in 67.2% of the ICH patients and in 53.3% of the SAH patients is similar to some previous studies of patients with ICH^!5,18 and SAH1M8.21. Yamour et al 25 found this abnormality in only 10% of 50 cases of spontaneous cerebral hemorrhage. However, these authors only included pa tients without previous hypertension and whose earlier ECG were normal.…”

Section: Commentsmentioning

confidence: 95%

Electrocardiographic findings in acute cerebrovascular hemorrhage a prospective study of 70 patients

Arruda

Lacerda²

1992

Arq. Neuro-Psiquiatr.

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In 1938, Asehenbrenner and Bodeehteis stated that intracranial lesions may be responsible for electrocardiographic abnormalities, but the first report of ECG changes in patients with cerebrovascular accidents was given by Byer, Ashman and Toth, in 1947 6. in 1954, Burch, Meyers and AbildskovS described a pattern of QT prolongation, abnormal T waves, and U waves which they considered distinctive of acute stroke. Since then, several reports about the prevalence and pathophysiology of ECG findings in different cerebrovascular events has accumulated 4,5,

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“…Concurrent stroke and evidence of MI are not infrequent, with angina, MI, or evidence of cardiac ischemia present in up to 6% of patients with acute stroke, although associations with elevation of biomarkers of myocardial injury and left ventricular wall motion abnormalities vary by stroke type and location, noted particularly in association with subarachnoid hemorrhage. 335,345,346 It has been postulated that these changes occur via a centrally mediated release of cat echolamines resulting in subendocardial ischemia with elevation of cardiac biomarkers, although even this el evation is inconsistent and not clearly associated with remediable ischemia. [347][348][349] Given the clear association between risk of stroke and incident cardiac disease, a high index of suspicion for inducible myocardial isch emia must be maintained in patients with acute stroke.…”

Section: Arrhythmia Monitoring Can Be Useful For Amentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

206

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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Electrocardiographic changes in cerebrovascular hemorrhage

Cited by 134 publications

References 22 publications

Right Sylvian Fissure Subarachnoid Hemorrhage Has Electrocardiographic Consequences

Right Sylvian Fissure Subarachnoid Hemorrhage Has Electrocardiographic Consequences

Electrocardiographic findings in acute cerebrovascular hemorrhage a prospective study of 70 patients

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

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