CARDIAC COMPLICATIONS IN ACUTE ISCHAEMIC STROKE WITH SPECIAL REFERENCE TO VENTRICULAR DYSFUNCTION

To characterize cardiac complications occurring in acute ischaemic/thrombotic stroke patients admitted to the medical emergency at a tertiary care hospital in Chennai, South India. Many extensive studies have been made in the past regarding cardiac complications in haemorrhagic stroke, especially SAH. METHODS Observational study (Prospective cum retrospective) done in acute ischaemic stroke patients admitted within 24 hours of symptom onset. Patients with haemorrhage in CT, age less than 18 and TIA were excluded. Electrocardiogram and Echocardiography were performed at admission and at the end of 48 hours. RESULTS Hundred patients were included in this study. In our study group 39 patients had an ejection fraction less than 50%, 20 patients had ischaemic changes in the ECG, 11 patients presented with atrial fibrillation and one developed a ventricular tachycardia. Subgroup analysis revealed a higher NIHSS score among those with systolic dysfunction with ejection fraction less than 40% (10% versus 2%; p<0.001), atrial fibrillation on ECG (9% versus 3%; p<0.05), ischaemic changes on ECG (17% versus 3%; p<0.05) compared with those without these changes. CONCLUSION A subset of acute ischaemic stroke patients may have cardiac complications. Systolic dysfunction, atrial fibrillation and ischaemic changes on ECG may be associated with higher in-hospital mortality rate as indirectly evidenced by the significant correlation of cardiac complications with severity of stroke. These findings support the importance of the adjunctive role of cardiac monitoring strategies in acute ischaemic stroke.