Cardiac Involvement in Patients With Acute Neurologic Disease

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Abstract
PATIENTS with acute neurologic illness often manifest electrocardiographic (ECG) abnormalities suggestive of cardiac injury. The classic ECG changes of deep T-wave inversion were initially described in 19381 and occur most often after subarachnoid hemorrhage, although they also have been described after thromboembolic strokes, intracranial space–occupying lesions, and meningitis.2-4 The etiology of these ECG changes and their prognostic significance is unclear. The lack of specificity of elevations of total creatine kinase (CK) and also, to some extent, CK-MB elevations have confounded attempts to better define the presence of myocardial injury in this group because these patients often have concomitant skeletal muscle injury related to the presence of seizures or direct skeletal muscle trauma.5-8