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Gepubliceerd in: Netherlands Heart Journal 10/2022

Open Access 03-05-2022 | Heart Beat

Abnormal electrocardiogram T wave pattern in ischaemic stroke

Auteurs: C. Soares, M. Temtem, A. Sá, R. Rodrigues

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2022

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An 88-year-old female with a history of hypertension, dyslipidaemia and hypothyroidism but without known pre-existing heart disease arrived at the primary care emergency services with sudden confusion and agitation. On admission, electrocardiography (ECG) showed sinus rhythm (SR) with bizarre and distorted T waves associated with a prolonged QTc interval (589 ms) in leads V2–V6 (Fig. 1a). She was transferred to hospital, and ECG was repeated 2 h later, which showed a different pattern: SR and prolonged QTc interval without the previous ST-T changes (Fig. 1b). Cerebral computed tomography (CT) imaging identified an ischaemic area in the right temporal-occipital-parietal cortex (Fig. 1c). The patient was discharged after 7 days, with moderate mental confusion.
Ischaemic strokes may be associated with ECG changes such as prolonged QT interval, ST-segment depression, T wave inversion or abnormal U waves. The precise mechanism has not yet been identified, but changes are usually transient [1]. There is a lack of evidence for prehospital ECG changes in acute stroke patients [2]. Recognition of this unusual pattern may point to a differential non-cardiac diagnosis and prevent delay in clinical decision-making and early treatment.

Conflict of interest

C. Soares, M. Temtem, A. Sá and R. Rodrigues declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
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Literatuur
1.
go back to reference Togha M, Sharifpour A, Ashraf H, et al. Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease. Ann Indian Acad Neurol. 2013;16:66–71. CrossRef Togha M, Sharifpour A, Ashraf H, et al. Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease. Ann Indian Acad Neurol. 2013;16:66–71. CrossRef
2.
go back to reference Munro SFS, Cooke D, Kiln-Barfoot V, et al. The use and impact of 12-lead electrocardiograms in acute stroke patients: A systematic review. Eur Heart J Acute Cardiovasc Care. 2018;7:257–63. CrossRef Munro SFS, Cooke D, Kiln-Barfoot V, et al. The use and impact of 12-lead electrocardiograms in acute stroke patients: A systematic review. Eur Heart J Acute Cardiovasc Care. 2018;7:257–63. CrossRef
Metagegevens
Titel
Abnormal electrocardiogram T wave pattern in ischaemic stroke
Auteurs
C. Soares
M. Temtem
A. Sá
R. Rodrigues
Publicatiedatum
03-05-2022
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 10/2022
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-022-01690-y

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Editor’s Comment

Age is no factor in TAVI