ECG changes may mimic AMI
Seen with almost any neurological type event (Stroke, SDH, EDH, Seizures, SAH)
Caused by autonomic dysfunction and catecholamine surges (BP in stroke)
Commonest changes: Prolonged QTc, ST / T changes (peaked or globally inverted)
Up to 90% of stroke patients have transient (but significant) ECG changes (1/2 have long QTc, 1/3 T wave inversion).
Commonest arrhythmias are PVCs but may also see VT or brady-arrhythmias.
Classical "takotsubo cardiomyopathy" (? adrenergic cardiac dysfunction) =
- SAH
- Transient ventricular wall dysfunction
- Transiently raised cardiac biomarkers
- Normal normal coronary architecture
ECG findings similar to Wellen's syndrome which can only be excluded by coronary angiography.