Published: 2018-09-22

Study of ECG changes in patients with acute stroke: a hospital based cross sectional study

Rambabu M. V., Viswajyothi Rao P.


Background: Physicians are confronted on having ECG in patients with acute stroke as it can mimic that of myocardial infarction/ischemia. They should be aware of these changes taking place in patients with acute stroke and not due to myocardial infarction/ischemia. The objective of the present study was to study ECG changes in patients with acute stroke.

Methods: A hospital based cross sectional study was carried out for a period of six months at Malla Reddy Hospital. A total of 100 patients were included who were eligible for the presents study as per the inclusion and exclusion criteria. Detailed clinical examination, history, lipid profile, blood pressure, BMI, addictions, RBS and ECG were done for all selected patients. Data was analysed using means, proportions. Statistical tests like chi square test and t test were used.

Results: Majority of patients with acute stroke were above 60 years of age, males, urban residents, professional and skilled persons, and alcoholics. Based on the study of ECG among patients with acute stroke it was found that T wave inversion was the most common ECG change found in 33% and this was more in females (36.1%) compared to 31.3% in males. LVH was next common condition found on ECG of acute stroke patients but this time its incidence was more in males (25%) compared to females with only 13.9%. Factors like age, BMI, SBP, DBP, TC, TG, LDL, VLDL, HDL, addictions, residence, sex, family history were not found to be associated with ECG changes.

Conclusions: T wave inversion and left axis deviation along with left ventricular hypertrophy were common ECG changes in patients with acute stroke. No studied factor was found to be associated with ECG changes in patients with acute stroke.


Acute stroke, ECG changes, Lipid profile

Full Text:



Alter M, Zhang ZX, Sobel E, Fisher M, Davanipour Z, Friday G. Standardized incidence ratios of stroke: a worldwide review. Neuroepidemiol. 1986;5(3):148-58.

Sommargren CE. Electrocardiographic abnormalities in patients with subarachnoid hemorrhage. Am J Crit Care. 2002 Jan;11(1):48-56.

Sakr YL, Lim N, Amaral AC, Ghosn I, Carvalho FB, Renard M et al. Relation of ECG changes to neurological outcome in patients with aneurysmal subarachnoid hemorrhage. Int J Cardiol. 2004 Sep; 96(3):369-73.

Solenski NJ, Haley EC Jr, Kassell NF, Kongable G, Germanson T, et al. Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Participants of the Multicenter Cooperative Aneurysm Study. Crit Care Med. 1995 Jun; 23(6):1007-17.

Togha M, Sharifpour A, Ashraf H, Moghadam M, Sahraian MA. Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease. Ann Indian Acad Neurol. 2013;16(1):66-71.

Khechinashvili G, Asplund K. Electrocardiographic changes in patients with acute stroke: a systematic review. Cerebrovasc Dis. 2002;14(2):67-76.

McDermott MM, Lefevre F, Arron M, Martin GJ, Biller J. ST segment depression detected by continuous electrocardiography in patients with acute ischemic stroke or transient ischemic attack. Stroke. 1994;25(9):1820-4.

Stanojevic M, Stankov S. Electrocardiographic changes in patients with chronic anemia. Srp Arch Celok Lek. 1998;126(11-12):461-6.

Dogan A, Tunc E, Ozturk M, Erdemoglu AK. Comparison of electrocardiographic abnormalities in patients with ischemic and hemorrhagic stroke. Anadolu Kardivo Derg. 2004;4(2):135-40.

Liu Q, Ding Y, Yan P, Zhang JH, Lei H. Electrocardiographic abnormalities in patients with intracerebral hemorrhage. Acta Neurochir Suppl. 2011;111:353-6.

Schuiling WJ, Algra A, de Weerd AW, Leemans P, Rinkel GJ. ECG abnormalities in predicting secondary cerebral ischemia after subarachnoid haemorrhage. Acta Neurochirurgica. 2006 Aug 1;148(8):853-8.