ECG changes with intracranial events

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) =

ECG findings similar to Wellen's syndrome which can only be excluded by coronary angiography.

Content by Dr Íomhar O' Sullivan 08/04/2011. Last review Dr ÍOS 10/06/21