A Study Of Prognosis Of Stroke With Special Reference To Electrocardiographic Changes And 2d-Echo.

Introduction: Stroke is the second most common cause of death and major cause of disability worldwide. Approximately 20 million people each year suffer from stroke of which 5 million do not survive. Cerebral infarction is responsible for about 80% of all rst ever in a lifetime strokes. There are many risk factors for cerebrovascular accidents like hypertension, diabetes, aneurysm & coagulopathy . This study was undertaken to determine ECG changes in stroke with diabetic and its prognostic signicance. Aims & Objectives: The present study aims to determine the 2D ECHO and ST-T changes among stroke patients and its implication in assessing prognosis. Material and Methods: The present study was carried out in100 patients admitted in department of medicine, S.S. medical college and associated S.G.M.H hospital, Rewa (M.P.) from july 2014 to Jun. 2015. Inclusion Criteria: The stroke patients of both sexes aged >16 years admitted to SGMH, Rewa. Neurodecit lasting >24 hours. Detailed neurological examination including fundoscopy and cardiovascular examination was carried out in all the cases. A12 lead ECG was done within 24 hours of admission. Result: th th Stroke was most common in 5 and 6 decade (55%). Males had higher preponderance among stroke patients (Male-female ratio 1.5:1). Hypertension was the most common risk factor in 45% of patients. In infarct the most common presenting complaints were headache(25%), Vomiting(19.11%) & Convulsion(8.82%). Such complaints were signicantly higher in hemorrhage Headache(65.62%), vomiting(78.12%) & convulsion(12.50%). Abnormal ECG changes were more common among hemorrhagic patients (78.12%) compared to infarct patients (67.64%). LVdysfunction was the most common abnormality noted in both groups i.e., infarct (23.53%) and hemorrhage (56.26%). Conclusion: ST segment depression in infarct(30%),hemorrhage(53.33%), QTc prolongation infarct(35.71),hemorrhage(46.66%) and prominent U wave infarct(50%),hemorrhage(53.33%) are the common ECG abnormalities in strokes. ECG abnormalities in stroke patients do not have any prognostic signicance. 2D echo abnormalities were more common among hemorrhage group (75%) than in infarct (44.12%). LV dysfunction showed signicant mortality in stroke patients and was statistically signicant (p<0.001).

QT Interval Abnormalities in Korean Women with Anorexia Nervosa / 대한정신약물학회지

OBJECTIVE: Anorexia nervosa carries the highest mortality of any psychiatric disorder with largely attributed to a cardiovascular etiology. The aim of this study was to evaluate QT alteration and the factors to influence the QT alteration. METHODS: We evaluated a hospital cohort of patients with anorexia nervosa (n=78) and age-matched healthy women (n=89). The QT, QT dispersion and U wave were measured from electrocardiograms in both patients and controls, and QT was corrected for heart rate using Bazett's formula. We also gathered the data for serum electrolytes, cholesterol, uric acid, creatinine, thyroid hormone, and bone mineral density. RESULTS: QT dispersion was significantly greater in patients with anorexia nervosa whereas corrected QT interval did not differ between groups. U wave tended to appear more frequently in patients with anorexia nervosa. QT dispersion was influenced by lowest ever body mass index and serum thyroid hormone. CONCLUSION: QT dispersion and U wave look to be more reliable index than heart rate-corrected QT, which may reflect arrhythmia potential in patients with anorexia nervosa. Lowest ever body mass index and current metabolic status could be predictive factors to cardiac arrhythmia in anorexia nervosa. Longitudinal follow-up study to evaluate risk as well as protective factors to cardiac mortality is warranted.

The Evaluation of Coronary Artery Stenosis by Exercise-Induced Negative U Wave

BACKGROUND: Negative U wave is frequent maker of systemic hypertension, aortic or mitral regurgitation and myocardial ischemia. This study was undertaken to determine the diagnostic significance of exercise-induced negative U wave in coronary artery stenosis. METHOD: 72 patients(46 men and 26 women ; 24~66 years of age) with chest pain were analysed with exercised-induced negative U wave and coronary angiographic finding. RESULT: Exercise-induced negative U wave was seen in 14 patients(19%). Among 14 patients with exercise-induced negative U wave, the predictive value of significant coronary artery stenosis(> or =75% stenosis of major coronary artery) was 71%, Exercise-induced negative U wave is more prevalent in patients with significant coronary artery stenosis(p<0.05). CONCLUSION: Exercise-induced negative U wave is a good marker of significant coronary artery stenosis.

Torsades de Points: análise de 105 episódios / Torsades de Pointes: analysis of 105 episodes

Purpose - To analyze episodes of Torsades de Pointes (TP), in search of its electrocardiographic characteristics. Patients and Methods - We analyzed 105 episodes of TP, in 4 patients using quinidine and diuretics, recorded by 24-hour Holter monitoring The following parameters were studied; ventricular repolarization out of TP, rhythm disturbances before TP; EKG characteristics of the onset, the bouts and the end of the TP. Results - Ventricular repolarization, out of the TP, was abdormal, with the presence of U-waves at the end of the T-waves, resulting in prolongation of the QT (QU) interval. The U-wave voltage was noted to be cycle-lenght dependent. Ventricular bigeminy preceded TP in 100 episodes (95%) and the mean interval between both parameters was 18 ±16 min. The onset of the TP episodes showed the "short/long/ short cycle rale", hereby called "pre-pause cycle", "preparing cycle" and "trigger cycle" respectively. The rotatory QRS-T morphology around the baseline, was seen in 75% of episodes, at the beginning or throughtout the bout. Monomorphic ventricular tachycardia pattern was seen in the other 25% of episodes. Termination of bouts was sudden in all cases, and persistent ventricular bigeminy led to another bout in 90 episodes (85% ). Conclusion - In TP patients, there is enlargement of QT intervals mostly due to U-waves appearence. The U-waves seen in these cases, probably have an important role in the genesis of TP and are probably related to ventricular after potentials (triggered activity). Ventricular bigeminy is a premonitory sign of TP in patients using class 1A antiarrhythmic drugs Persistent ventricular bigeminy post-TP episoaes is a strong indicator of another bout of TP. The onset of TP is more important than its morphology for the correct diagnosis of this arrhythmia