Prognostic Significance of Electrocardiography and Echocardiography in patients of Acute Stroke

M. Indurkar; R. K. Kewat; K. D. Singh

Volume : VIII, Issue : XII, December - 2019

Prognostic Significance of Electrocardiography and Echocardiography in patients of Acute Stroke

M. Indurkar, R. K. Kewat, K. D. Singh

Abstract :

Introduction: World Health Organization (WHO) definition of stroke is: “rapidly developing clinical signs of focal (or global) disturbance of cereal function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than of vascular origin Cereovascular accident (CVA) or stroke is the most common life threatening or disabling neurological condition in older population. CVA is often associated with ECG changes and wall motion abnormalities on 2D echo. The changes of ECG in CVA were reported were T–wave, U–wave, ST–segment, QT–interval and various arrhythmias, these ECG changes may resemble those of myocardial ischemia or sometime myocardial infarction. The aim of this study is to assess the different changes in ECG and echocardiographic patterns in the cases of cereovascular accidents and to determine whether these different changes have got any prognostic significance in these cases. Method: 200 patients of acute stroke were considered and ECG and 2D echo of these patients were done within 24 hours of admission. In hospital follow–up was done to know the prognosis of all the patients. Results: ECG abnormalities noted among cereal infarct group were presence of U– waves (51.47%), prolonged QTc (36.76%) were most common followed by T–wave inversion (30.88%), and ST segment depression (30.88%). In cases of hemorrhagic stroke, ST depression (56.26%) and U–wave (56.26%) were the most common abnormalities. LV dysfunction was the most common 2D echo abnormality in both the stroke types – 23.53% and 81.8% i.e., in infarct and hemorrhage groups respectively. Mortality was high in patients with abnormal ECG (24%) as compared to normal ECG (17.2%) (p>0.5). Mortality was high in patients with abnormal 2D echocardiography (90.91%) as compared to normal 2D ECHO(9.09%) (p<0.001). Conclusion: ST segment depression, QTc prolongation and U–waves are the common ECG abnormalities in hemorrhagic strokes. QTc prolongation and U–waves are the common ECG abnormality in ischemic stroke. LV dysfunction is the most common 2D echocardiographic abnormality in stroke patients. ECG abnormalities in stroke patients do not have any prognostic significance. LV dysfunction has prognostic significance in predicting mortality in CVA.