Ischemic stroke electrocardiogram: Difference between revisions
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{{ | {{Ischemic stroke}} | ||
{{CMG}} | {{CMG}}{{AE}}{{AA}} | ||
==Overview== | ==Overview== | ||
An [[electrocardiogram]] (ECG) may be performed to determine the underlying etiology such as [[cardiac arrhythmia|arrhythmias]] which may result in clots in the heart that may spread to the brain vessels through the bloodstream. A [[Holter monitor]] may be used to identify intermittent arrhythmias. | An [[electrocardiogram]] (ECG) may be performed to determine the underlying etiology such as [[cardiac arrhythmia|arrhythmias]] which may result in clots in the heart that may spread to the brain vessels through the bloodstream. A [[Holter monitor]] may be used to identify intermittent arrhythmias. | ||
==Electrocardiogram== | |||
ECG findings in patients of ischemic stroke may help determine the following:<ref name="pmid21804776">{{cite journal| author=Ustrell X, Pellisé A| title=Cardiac workup of ischemic stroke. | journal=Curr Cardiol Rev | year= 2010 | volume= 6 | issue= 3 | pages= 175-83 | pmid=21804776 | doi=10.2174/157340310791658721 | pmc=2994109 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21804776 }} </ref><ref name="pmid23661966">{{cite journal| author=Togha M, Sharifpour A, Ashraf H, Moghadam M, Sahraian MA| title=Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease. | journal=Ann Indian Acad Neurol | year= 2013 | volume= 16 | issue= 1 | pages= 66-71 | pmid=23661966 | doi=10.4103/0972-2327.107710 | pmc=3644785 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23661966 }} </ref> | |||
*Underlying cause for ischemic stroke such as embolic source in [[atrial fibrillation]], ongoing myocardial ischemia, chronic myocardial injury and valvular abnormalities. | |||
*ECG monitoring in first 24 hours may help determine the new onset or paroxysmal atrial fibrillation. | |||
*May determine cardiac complications of acute ischemic stroke such as myocardial ischemia or arrythmias. | |||
== 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association<ref name="pmid34024117">{{cite journal| author=Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D | display-authors=etal| title=2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. | journal=Stroke | year= 2021 | volume= 52 | issue= 7 | pages= e364-e467 | pmid=34024117 | doi=10.1161/STR.0000000000000375 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34024117 }}</ref> == | |||
=== Recommendations for Diagnostic Evaluation Referenced studies that support recommendations are summarized in online Data Supplements 1 and 2 === | |||
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| colspan="1" style="text-align:center; background:LightGreen" |[[EHS ESC guidelines classification scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen" |1. In patients suspected of having a stroke or TIA, an ECG is recommended to screen for atrial fibrillation (AF) and atrial flutter and to assess for other concomitant cardiac conditions. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])''<nowiki>"</nowiki> | |||
|} | |||
{| class="wikitable" | |||
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| colspan="1" style="text-align:center; background:LemonChiffon" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |||
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| bgcolor="LemonChiffon" |7. In patients with cryptogenic stroke who do not have a contraindication to anticoagulation, long-term rhythm monitoring with mobile cardiac outpatient telemetry, implantable loop recorder, or other approach is reasonable to detect intermittent AF.([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of Evidence: B-R'']]) | |||
|} | |||
'''For AHA/ASA guidelines for cardiac monitoring in patients with ischemic stroke, please''' [[AHA/ASA guideline recommendations for of Early management of acute ischemic stroke#General Supportive Care and Treatment of Acute Complications|click here]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WS}} | {{WS}} | ||
{{WH}} | {{WH}} | ||
Latest revision as of 14:07, 12 January 2023
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Ischemic Stroke Microchapters |
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Ischemic stroke electrocardiogram On the Web |
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American Roentgen Ray Society Images of Ischemic stroke electrocardiogram |
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Risk calculators and risk factors for Ischemic stroke electrocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
An electrocardiogram (ECG) may be performed to determine the underlying etiology such as arrhythmias which may result in clots in the heart that may spread to the brain vessels through the bloodstream. A Holter monitor may be used to identify intermittent arrhythmias.
Electrocardiogram
ECG findings in patients of ischemic stroke may help determine the following:[1][2]
- Underlying cause for ischemic stroke such as embolic source in atrial fibrillation, ongoing myocardial ischemia, chronic myocardial injury and valvular abnormalities.
- ECG monitoring in first 24 hours may help determine the new onset or paroxysmal atrial fibrillation.
- May determine cardiac complications of acute ischemic stroke such as myocardial ischemia or arrythmias.
2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association[3]
Recommendations for Diagnostic Evaluation Referenced studies that support recommendations are summarized in online Data Supplements 1 and 2
| Class I |
| 1. In patients suspected of having a stroke or TIA, an ECG is recommended to screen for atrial fibrillation (AF) and atrial flutter and to assess for other concomitant cardiac conditions. (Level of Evidence: B-R)" |
| Class IIa |
| 7. In patients with cryptogenic stroke who do not have a contraindication to anticoagulation, long-term rhythm monitoring with mobile cardiac outpatient telemetry, implantable loop recorder, or other approach is reasonable to detect intermittent AF.(Level of Evidence: B-R) |
For AHA/ASA guidelines for cardiac monitoring in patients with ischemic stroke, please click here
References
- ↑ Ustrell X, Pellisé A (2010). "Cardiac workup of ischemic stroke". Curr Cardiol Rev. 6 (3): 175–83. doi:10.2174/157340310791658721. PMC 2994109. PMID 21804776.
- ↑ Togha M, Sharifpour A, Ashraf H, Moghadam M, Sahraian MA (2013). "Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease". Ann Indian Acad Neurol. 16 (1): 66–71. doi:10.4103/0972-2327.107710. PMC 3644785. PMID 23661966.
- ↑ Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D; et al. (2021). "2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association". Stroke. 52 (7): e364–e467. doi:10.1161/STR.0000000000000375. PMID 34024117 Check
|pmid=value (help).