ECG Changes in Intracranial Hemorrhage
ECG Changes in Intracranial Hemorrhage
ECG changes are fairly common in intracranial hemorrhage. Giant T inversions with QT interval prolongation may be seen in intracranial hemorrhage even without associated myocardial damage [1]. ECG changes described in subarachnoid hemorrhage include QT interval prolongation, T wave abnormalities and ST segment deviations. Mechanism is thought to be due to sustained sympathetic stimulation, probably caused by dysfunction of insular cortex resulting in reversible neurogenic damage to the myocardium which could include contraction bands and subendocardial ischemia [2].
In a study involving patients with supratentorial hemorrhage, they found that ECG changes were more common in basal ganglia and thalamic bleeds rather than in lobar bleeds. But the number of persons with lobar hemorrhage in that study was only 17%. In that study commonest ECG abnormalites were QTc prolongation followed by brady/tachycardia and then ST segment deviations [3]. Cerebrovascular damage can cause cardiac arrhythmias related to disinhibition of right insular cortex with resulting increased sympathetic tone. Risk is thought to be higher with damage to right hemisphere than left hemisphere.
ECG changes resembling ST elevation myocardial infarction has also been described after traumatic intracranial hemorrhage [4]. Serial measurements of cardiac enzymes were normal in that case. According to J Willis Hurst, it is likely to be due to severe generalized epicardial injur...
Source: Cardiophile MD - Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
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