Electrocardiographic and Echocardiographic Alterations in Patients with Acute Cerebrovascular Stroke

Abstract

Background: Stroke, a leading cause of morbidity and mortality, is often accompanied by significant cardiovascular changes, which may complicate management and affect patient outcomes. This study explores electrocardiographic (ECG) and echocardiographic changes in patients during the acute phase of stroke, focusing on the prevalence, types, and implications of these findings.

Methods: This hospital-based, cross-sectional study was conducted at ESIC Medical College & PGIMSR, enrolling 76 patients with acute ischemic or hemorrhagic stroke. Each patient underwent 12-lead ECG, cardiac troponin-I testing, and echocardiographic evaluation, including assessments for left ventricular ejection fraction, left ventricular hypertrophy (LVH), and regional wall motion abnormalities (RWMA). Data were analyzed to identify the prevalence and types of ECG and echocardiographic changes and their association with patient demographics and stroke type.

Results: The study population’s largest age group was 71–80 years (30.3%), with 61.8% male participants. Most patients (81.6%) had hypertension, 42.1% were smokers, 32.9% had type 2 diabetes, and 78.9% had ischemic stroke. Common ECG findings included prolonged QTC (46%), T-wave abnormalities (42.1%), and ST-segment depression (28.9%). Atrial fibrillation was the most common arrhythmia (13.2%), followed by sinus arrhythmia and sinus bradycardia (each 6.6%). Echocardiographic findings showed LVH in 25% of patients, RWMA in 19.7%, and left atrial thrombus in 6.6%. Patients with hemorrhagic stroke demonstrated higher rates of prolonged QTC and T-wave abnormalities compared to ischemic stroke patients.

Conclusion: This study highlights a high prevalence of ECG and echocardiographic changes in acute stroke patients, particularly in those with hemorrhagic stroke. These findings underscore the importance of routine cardiovascular evaluation in stroke patients to detect and manage cardiac complications early. Further studies are warranted to explore the implications of these cardiac abnormalities on stroke outcomes and recovery.