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EKG changes associated with Stroke
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EKG changes associated with Stroke

Is there any type of 12 Lead EKG changes that you may see when a Stroke (Hemmorage or Emboli in nature)?
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
    There are a number of EKG changes that can be associated with strokes, both as effects of the stroke and changes that are associated with causing stroke.  The brain is involved regulating the heart rate by sympathetic and parasympathetic (autonomic) control.  This control is enacted by the relases of different chemical that slow down or speed up the heart rate.  A stroke in the region that controls the autonomic output (such as the right insular cortex or hypothalamus) can lead to a high dose of the regulatory chemical being relased.  This can lead to a heart attack  and/or cardiac arrhytmias.  The EKG changes seen after 'stroke' can be S-T elevation, sinus tachycardia, elevated T waves (or depressed) prolongation of the QT interval and U waves (I hope that was not too technical, but you can discuss these with your doctor).  Some hemorrhages can also have influence on the EKG in a similar fashion, most notably subarrachnoid hemorrhage.  The exact mechanism of the EKG changes related to stroke/hemorrhage are still under investigation, but the best theory so far is the autonomic theory as I presented above.  EKG can not be used to differentiate between embolic versus hemorrhagic stroke, this is done by CT/MRI of the brain.  An frequent EKG finding that is associated with stroke is new onset atrial fibrillation.  This is a disorganized, irregular heart beat that allows blood to clot inside the heart, and then these clots can travel to the brain causing a stroke.  This EKG pattern is often found when a patient presents with stroke (usually embolic) but the EKG pattern does not result from the stroke, the condition of atrial fibrillation caused the stroke.  
I hope this has been helpful.
2 Comments
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Avatar_f_tn
i believe there are may be T-wave inversions in lateral leads (???)  not sure.  it is more common with some strokes vs others.
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