EKG abnormalities in central nervous system disease

WikiDoc Resources for EKG abnormalities in central nervous system disease
Articles
Most recent articles on EKG abnormalities in central nervous system disease Most cited articles on EKG abnormalities in central nervous system disease Review articles on EKG abnormalities in central nervous system disease Articles on EKG abnormalities in central nervous system disease in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on EKG abnormalities in central nervous system disease Images of EKG abnormalities in central nervous system disease Photos of EKG abnormalities in central nervous system disease Podcasts & MP3s on EKG abnormalities in central nervous system disease Videos on EKG abnormalities in central nervous system disease
Evidence Based Medicine
Cochrane Collaboration on EKG abnormalities in central nervous system disease Bandolier on EKG abnormalities in central nervous system disease TRIP on EKG abnormalities in central nervous system disease
Clinical Trials
Ongoing Trials on EKG abnormalities in central nervous system disease at Clinical Trials.gov Trial results on EKG abnormalities in central nervous system disease Clinical Trials on EKG abnormalities in central nervous system disease at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on EKG abnormalities in central nervous system disease NICE Guidance on EKG abnormalities in central nervous system disease NHS PRODIGY Guidance FDA on EKG abnormalities in central nervous system disease CDC on EKG abnormalities in central nervous system disease
Books
Books on EKG abnormalities in central nervous system disease
News
EKG abnormalities in central nervous system disease in the news Be alerted to news on EKG abnormalities in central nervous system disease News trends on EKG abnormalities in central nervous system disease
Commentary
Blogs on EKG abnormalities in central nervous system disease
Definitions
Definitions of EKG abnormalities in central nervous system disease
Patient Resources / Community
Patient resources on EKG abnormalities in central nervous system disease Discussion groups on EKG abnormalities in central nervous system disease Patient Handouts on EKG abnormalities in central nervous system disease Directions to Hospitals Treating EKG abnormalities in central nervous system disease Risk calculators and risk factors for EKG abnormalities in central nervous system disease
Healthcare Provider Resources
Symptoms of EKG abnormalities in central nervous system disease Causes & Risk Factors for EKG abnormalities in central nervous system disease Diagnostic studies for EKG abnormalities in central nervous system disease Treatment of EKG abnormalities in central nervous system disease
Continuing Medical Education (CME)
CME Programs on EKG abnormalities in central nervous system disease
International
EKG abnormalities in central nervous system disease en Espanol EKG abnormalities in central nervous system disease en Francais
Business
EKG abnormalities in central nervous system disease in the Marketplace Patents on EKG abnormalities in central nervous system disease
Experimental / Informatics
List of terms related to EKG abnormalities in central nervous system disease

Cardiology Network
Discuss EKG abnormalities in central nervous system disease further in the WikiDoc Cardiology Network
Adult Congenital
Biomarkers
Cardiac Rehabilitation
Congestive Heart Failure
CT Angiography
Echocardiography
Electrophysiology
Cardiology General
Genetics
Health Economics
Hypertension
Interventional Cardiology
MRI
Nuclear Cardiology
Peripheral Arterial Disease
Prevention
Public Policy
Pulmonary Embolism
Stable Angina
Valvular Heart Disease
Vascular Medicine

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

Overview

Classic manifestations on EKG of the so-called CVA (cerebrovascular accident, most commonly associated with subarachnoid hemorrhage or other intracranial bleeds) are deep inverted giant T wave inversion. The mechanisms are not fully delineated but may relate to excessive catecholamine stimulation causing direct myocardial injury. Takostubo syndrome may occur in some cases. The long QT-U may predispose to torsade(s) de pointes. The ECG may be notable for marked QT-U prolongation (sometimes a giant U wave appears to be appended to the T wave, creating a slight discontinuity in waveform morphology). Apical hypertrophic cardiomyopathy (Yamaguchi’s syndrome) is associated with deep, but relatively narrow (spade-like) T wave inversions, most marked in the mid-precordial leads.

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

Template:WikiDoc Sources