EKG abnormalities in central nervous system disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Electrocardiographic Findings:

1. EKG changes seen in 71.5% of patients with subarachnoid hemorrhage, and 57.1% of those with cerebral hemorrhage.
2. Most common abnormalities are
   • Large, upright, or deeply inverted T waves
   • Prolongation of the QTc interval
   • Prominent U waves
3. Can persist for 11 days
4. Rarely can ST segment elevation or depression
5. Rhythm disturbances
   • Sinus bradycardia
   • Sinus tachycardia
   • Wandering atrial pacemaker
   • AV junctional rhythm
   • Premature ventricular contractions PVCs
   • Ventricular tachycardia (VT)
6. Reason for changes is thought to be altered autonomic tone

Examples

• 
  Patient with subaracnoidal hemorrhage
• 
  EKG of a patients with CNS Disorders
• 
  Inverted and deep T waves in the precordal leads due to subaracnoidal aneurysm [Image courtesy of Dr Jose Ganseman Dr Ganseman's webpage: An ultimate source of EKG

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