European Journal of Molecular & Clinical Medicine

Introduction:  Cerebrovascular accident (CVA) or stroke is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Cerebrovascular accidents (CVA) can be classified into two major categories: about 87% of strokes are ischemic, the rest being haemorrhagic.Studies have demonstrated the fact that primary neurologic abnormalities may produce ECG changes without any myocardial lesion.
Aim: To study the various types of ECG changes in patients of cerebrovascular accidents. To compare the ECG changes in patients of haemorrhagic and ischemic cerebrovascular accidents.
Material and methods: This present study was carried out in 50 cases diagnosed as CVA admitted in the Department of Medicine in a tertiary care hospital of Punjab(North India) after obtaining their informed consent.All patients with CVA of less than 10 days duration admitted in the Department of Medicine were included in this study. A detailed history was taken and patients were selected as per inclusion and exclusion criteria. Along with other investigations 12 lead ECG tracing on admission and after 72 hours of stroke onset was performed. The ECGs were analysed for the occurrence of arrhythmias, ST-T segment changes, changes in various intervals and ectopic beats.
Results: In our study population of 50 patients, 38 (76%) patients were having ischemic stroke and 12 (24%) patients were having haemorrhagic stroke. In our study, prolonged QTc was the most common ECG abnormality.In our study, ST segment changes were most commonly noted in ischemic stroke.12% of patients with ischemic stroke had ST depression and 2% had ST elevation. In our study, sinus tachycardia was the most common rhythm change observed in both ischemic CVA(26%) and haemorrhagic CVA(36%) followed by sinus bradycardia.
Conclusion: This study showed male predominance in stroke cases. Cerebral infarction was more than haemorrhage.ECG changes were more commonly associated with ischemic stroke as compared to haemorrhagic stroke.Cardiac disturbances are diverse and frequent in the setting of acute neurological injury.Understanding of these ECG changes occurring in patients with CVA is important because it may lead to erroneous judgment of assigning these patients as CAD.These patient should be evaluated for cardiac injury and treated only if necessary.

Background: Arrhythmias and conduction disturbances those are likely to be significant problems during the early phases of AMI. The arrhythmias and conduction abnormalities discussed include sinus bradycardia, AV block, Idioventricular rhythm, VT, and VF. In general, the acute management of these rhythm disturbances is the same in the early and in the late phases of AMI
Materials & Methods: The present study was conducted in 100 patients of acute myocardial infarction to evaluate the incidence and significance of early and predischarge cardiac arrhythmias.
Results: By seventh hospital day, twenty patients had expired and the remaining eighty patients were monitored in CCU for two hours and arrhythmias were noted. Complicated ventricular premature contraction (i.e.Lown class III-V) was observed in two (25%) patient. Fifteen (18.75%) patients had Lown class 0-II VPC's. Two (2.5%) patients had supraventricular tachycardia and 6 (7.5%) patients had heart blocks.
Conclusion: Early arrhythmias (within 24 hours of AMI.) were significantly associated with in hospital mortality and complicated course, while no significant bearing on long term (6 month) cardiac event was noted.