EKG abnormalities in central nervous system disease: Difference between revisions

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{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
==Overview==
==Overview==
Classic manifestations on EKG of the so-called CVA (cerebrovascular accident, most commonly associated with subarachnoid hemorrhage or other intracranial bleeds) are deep inverted giant T wave inversion. The mechanisms are not fully delineated but may relate to excessive catecholamine stimulation causing direct myocardial injury. Takostubo syndrome may occur in some cases. The long QT-U may predispose to torsade(s) de pointes.  
Classic manifestations on EKG of the so-called cerebrovascular accident, (most commonly associated with subarachnoid hemorrhage or other intracranial bleeds) are deep inverted giant T wave inversion. The mechanisms are not fully delineated but may relate to excessive catecholamine stimulation causing direct myocardial injury. Takostubo syndrome may occur in some cases. The long QT-U may predispose to torsade(s) de pointes. The ECG may be notable for marked QT-U prolongation (sometimes a giant U wave appears to be appended to the T wave, creating a slight discontinuity in waveform morphology). Apical hypertrophic cardiomyopathy (Yamaguchi’s syndrome) is associated with deep, but relatively narrow (spade-like) T wave inversions, most marked in the mid-precordial leads.
The ECG may be notable for marked QT-U prolongation (sometimes a giant U wave appears to be appended to the T wave, creating a slight discontinuity in waveform morphology). Apical hypertrophic cardiomyopathy (Yamaguchi’s syndrome) is associated with deep, but relatively narrow (spade-like) T wave inversions, most marked in the mid-precordial leads.  
 
==Electrocardiographic Findings:==
==Electrocardiographic Findings:==
# EKG changes seen in 71.5% of patients with [[subarachnoid hemorrhage]], and 57.1% of those with [[cerebral hemorrhage]].
# EKG changes seen in 71.5% of patients with [[subarachnoid hemorrhage]], and 57.1% of those with [[cerebral hemorrhage]].

Revision as of 13:57, 11 August 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Classic manifestations on EKG of the so-called cerebrovascular accident, (most commonly associated with subarachnoid hemorrhage or other intracranial bleeds) are deep inverted giant T wave inversion. The mechanisms are not fully delineated but may relate to excessive catecholamine stimulation causing direct myocardial injury. Takostubo syndrome may occur in some cases. The long QT-U may predispose to torsade(s) de pointes. The ECG may be notable for marked QT-U prolongation (sometimes a giant U wave appears to be appended to the T wave, creating a slight discontinuity in waveform morphology). Apical hypertrophic cardiomyopathy (Yamaguchi’s syndrome) is associated with deep, but relatively narrow (spade-like) T wave inversions, most marked in the mid-precordial leads.

Electrocardiographic Findings:

  1. EKG changes seen in 71.5% of patients with subarachnoid hemorrhage, and 57.1% of those with cerebral hemorrhage.
  2. Most common abnormalities are
  3. Can persist for 11 days
  4. Rarely can ST segment elevation or depression
  5. Rhythm disturbances
  6. Reason for changes is thought to be altered autonomic tone

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