The electrocardiogram in stroke: relationship to pathophysiological type and comparison with prior tracings.

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Abstract
The author reviewed electrocardiographic records of 150 patients with acute stroke and 150 age- and sex-matched controls, to assess the relative frequencies of ECG abnormalities among the pathophysiologic categories of stroke, and to distinguish new abnormalities at the time of the stroke from those noted on prior tracings. Of the 150 patients with stroke, 138 (92%) showed ECG abnormalities. The most common abnormalities were also changes from prior tracings: QT prolongation (68 patients, 45%), ischemic changes (59, 35%), U waves (42, 28%), tachycardia (42, 28%), and arrhythmias (41, 27%). Patients with cerebral embolus had a significantly increased frequency of atrial fibrillation (9 patients, 47%); and with subarachnoid hemorrhage an increased frequency of QT prolongation (20, 71%) and sinus arrhythmia (5, 18%). The frequencies of QT prolongation and ischemic changes related strongly to admission systolic pressure but not to mortality. Stroke patients had an increased frequency of pathologic Q waves (30...