ELECTROCARDIOGRAPHIC CHANGES IN STROKE PATIENTS WITHOUT PRIMARY HEART-DISEASE

Consecutive electrocardiograms were recorded in 28 stroke patients wit hout signs of primary heart disease. Individuals with subarachnoidal h aemorrhage, or electrolyte disturbances were excluded. A computerized tomography of the brain was performed in each case and showed a cerebr al haemorrhage (n=4), cortical infarction (n=6), subcortical infarctio n (n=14) and normal finding (n=4). One patient developed atrial fibril lation but no other case of serious disturbances in rate or rhythm occ urred. None developed AV block, bundle branch blocks or significant ch anges in QRS complexes. The most common abnormalities in ECG were tran sient STT changes in lateral leads, which were seen in 13 cases. The t ypical findings were flat or slightly negative T waves, horizontal or down-sloping ST segments and sometimes a small ST depression. In no ca se did ECG show typical signs of acute myocardial infarction. A transi ent prolonged QT interval was seen in three patients and transient U w aves in four. ECG did not correlate to the location of the vascular le sion seen on CT or the clinical outcome. It is concluded that STT chan ges of a small magnitude are seen in about half of the cases of stroke patients without primary heart disease and that they do not resemble the typical pattern of acute myocardial ischaemia.