Abstract:
Background: - Physicians are confronted on having ECG
in patients with acute stroke as it can mimic that of
myocardial infarction or ischaemia. Repolarization and
ischemic-like electrocardiographic (ECG) changes
observed during acute phase of stroke may cause
diagnostic and management dilemmas for the physicians.
Aim:- The aim and objective of this study to identify the
prevalence of ECG changes in acute stroke patients
admitted to medicine units of Dhaka Medical College
Hospital.
Materials and Method: - This 6-month period
observational study was carried out among 100 of acute
stroke patients admitted in different medicine wards of
Dhaka Medical College Hospital (DMCH). ECG was
done in all patients after their admission to hospital
within 48 hours of developing their symptoms.
Association of various types of ECG changes were
identified and observed.
Results: - Among 100 patients,55% had ischaemic stroke
and 45% had haemorrhagic stroke. 43.63% aged between
61-70 years had ischaemic stroke and 28.28% aged
between 61-80 years had haemorrhagic stroke. Female
had higher frequency of ischaemic stroke 52.72% and
male had higher frequency of haemorrhagic stroke
75.56%. Abnormal ECG found 84.44% in haemorrhagic
stroke and 54.54% in ischaemic stroke. Of all abnormal
ECG, ST depression is most frequent and 42.22% in
haemorrhagic stroke, T inversion is next 20% in
ischaemic stroke, AF is present in 18.18% in ischaemic
stroke and QT prolongation is found in 17.77% in
hemorrhagic stroke. There considerable variation of
ECG changes according to CT scan evidence of
particular area of brain involvement like ST depression
(28.88%) found in gangliothalamic bleed in
haemorrhagic stroke, AF is found (16.36%) in insular
area involvement in ischaemic stroke, T inversion is more
(12.72%) in large MCA territory infarctive stroke and QT
prolongation (11.11%) is found in intracerebral
haemorrhage including SAH. Predictable early in
hospital mortality is associated with AF 37.5% and with
QT prolongation 31.25%.
Conclusion:- In haemorrhagic stroke the ECG
abnormalities were more frequent then in ischaemic
stroke. The most common abnormalities were ST
depression, T wave inversion, AF and QT prolongation.
AF and QT prolongation has association of early in
hospital mortality.
Keywords:- Acute Stroke , ECG Changes.