Pérez FA, Mederos HJ

Language: Spanish
References: 30
Page: 27-39
PDF size: 117.32 Kb.

ABSTRACT

Introduction: for the last hundred years the relationship between hemorrhagic cerebrovascular events and electrocardiographic alterations has been studied, as well as their significance as a prognostic factor for mortality.
Objective: to characterize the electrocardiographic alterations in patients with spontaneous intracerebral hemorrhage at their arrival to the Emergency Room.
Material and Method: an observational descriptive and transverse study was carried out between January 2010 and December 2011 in "Comandante Manuel Fajardo" University Hospital.
Results: it was found a predominance of females, with an average age of 70 years. The most frequent electrocardiographic alterations were sinus tachycardia, sinus bradycardia, and flat or inverted T waves. Around two thirds of the patients with these changes died in the hospital.
Conclusions: nearly 50% of patients presented with electrocardiographic anomalies on admittance. They prevailed in female patients and a statistically significant difference was found between them and adverse outcomes.

REFERENCES

1. Ikram MA, Wieberdink RG, Koudstaal PJ.International Epidemiology of Intracerebral Hemorrhage. Curr Atheroscler Rep. 2012; 14(4):300-6.

2. Longo DL, Kasper DL, Jameson JL, Fauci AS, Loscalzo J, editors. Harrison´s Principles of Internal Medicine. 18 ed. Washington: McGraw-Hill; 2012, pp 2270-2300.

3. Asch CJ, Luitse MJ, Rinkel GJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010; 9(2):167-76.

4. Dirección de Registros Médicos y Estadísticas de Salud. Anuario estadístico de salud 2014. La Habana: Ministerio de Salud Pública; 2015.

5. Suárez A, López E, García N, Sarmiento M. Predictores de mortalidad en la hemorragia intracerebral supratentorial espontánea. Rev Cub Med Int Emerg. 2014; 13(4):397-404.

6. Acosta L, López L, Molero M, Fonseca M, González A. Morbilidad y mortalidad por hemorragia cerebral. 1999-2000. Multimed. 2001, 21 ago; 5(4).

7. Byer E, Ashman R, Toth L. Electrocardiogram with large upright T waves and long Q-T intervals. Am Heart J. 1947; 33:796-9.

8. Manea MM, Comsa M, Minca A, Dragos D, Popa C. Brain-heart axis - Review Article. Journal of Medicine and Life. 2015; 8(3):266-71.

9. Carrillo R, García M, Martínez L. Caso clínico: Disfunción ventricular izquierda secundaria a hemorragia subaracnoidea. Rev Asociación Mexicana de Medicina Crítica. 2010; 24(4):196-200.

10. Frontera JA, Parra A, Shimbo D, Fernandez A, Schmidt JM, Peter P, et al. Cardiac arrhythmias after subarachnoid hemorrhage: risk factors and impact on outcome. Cerebrovasc Dis. 2008; 26:71-8.

11. Junttila E, Vaaram M, Koskenkari J, Ohtonen P, Karttunen A, Raatikainen P, et al. Repolarization abnormalities in patients with subarachnoid and intracerebral hemorrhage: predisposing factors and association with outcome. Anesth Analg. 2013; 116(1):190-7.

12. van Bree MDR, Roos YBW, van der Bilt IAC, Wilde AAM, Sprengers MES, Vergouwen MDI, et al. Prevalence and Characterization of ECG Abnormalities After Intracerebral Hemorrhage. Neurocrit Care. 2010; 12:50-5.

13. Hasegawa K, Fix ML, Wendell L, Schwab K, Ay H, Smith EE, et al. Ischemicappearing electrocardiographic changes predict myocardial injury in patients with intracerebral hemorrhage. Am J Emerg Med. 2012; 30(4): 545-52.

14. Hjalmarsson C, Bergfeldt L, Bokemark L, Manhem K, Andersson B. Electrocardiographic Abnormalities and Elevated cTNT at Admission for Intracerebral Hemorrhage: Predictors for Survival? Annals of Noninvasive Electrocardiology.2013;18:441-9.

15. Alemparte PE, Castro OMJ. Alteraciones transitorias del ECG y de la motilidad del ventrículo izquierdo durante la hemorragia subaracnoidea. Med Intensiva.2002;26(2):71-4.

16. Carrillo R, Carrillo LD, Carrillo CA, Carrillo JR. Alteraciones electrocardiográficas en hemorragia pontomesencefálica. Rev Asoc Mex Med Crit y Ter Int.2010; 24(3):145-8 pp.

17. Huang CH, Chen WJ, Chang WT. QTc dispersion as a prognostic factor in intracerebral hemorrhage. Am J Emerg Med . 2004; 22(3):141-4.

18. Liu Q, Ding Y, Yan P. Electrocardiographic abnormalities in patients with intracerebral hemorrhage. Acta Neurochir Suppl. 2011; 111:353-6.

19. Popescu D, Laza C, Mergeani A, O.A. B, Antochi FA. Lead Electrocardiogram Changes after Supratentorial Intracerebral Hemorrhage. Maedica. 2012; 7(4):290-4.

20. Sánchez J, Ortega L, Sera R. Alteraciones electrocardiográficas en el ictus hemorrágico. Rev Cub Med Int Emer. 2004; 3(3):20-6.

21. Bolaños S, Gómez Y, Rodríguez S, Dosouto V, Rodríguez M. Tomografía axial computarizada en pacientes con enfermedades cerebrovasculares hemorrágicas. MEDISAN. 2009; 13(5).

22. González A, Gómez N, Álvarez R, Ávila Y. Hemorragia intracerebral. Estudio de 349 autopsias en el Hospital Clinicoquirúrgico "Hermanos Ameijeiras". Rev cubana med. 2007; 46(2).

23. Oficina Nacional de Estadística e Información. Anuario Estadístico Municipal Plaza. La Habana:2013.

24. Zorrilla J, Sousa L, Ioli P, Romano LM, Spadaro E, Castellino G. Variables predictivas de letalidad y rendimiento de la escala ReC-HPC en hemorragia intracerebral primaria en pacientes anticoagulados. Neurología Argentina. 2011; 3(2):94-9.

25. Aguilera OR. Factores pronósticos en la hemorragia cerebral intraparenquimatosa. MEDISAN. 2012; 16(1).

26. Salazar Z, Rivera CL. Hematomas intracerebrales no traumáticos: factores pronósticos. Rev Chil Neurocir. 2006;27(1):42-6.

27. Keep RF, Hua Y, Xi G. Intracerebral haemorrhage: mechanisms of injury and therapeutic targets. The Lancet Neurology. 2012 11(8):720-31.

28. Ay H, Koroshetz WJ, Benner T. Neuroanatomic correlates of strokerelatedmyocardial injury. Neurology. 2006; 66:1325.

29. Fernández MC, Castilla L, Aguilera JM, Jiménez MD. Hemorragia intracerebral. Medicine. 2007; 9(73):4647-55.

30. Salas JH. Presión intracraneal. La Habana: Editorial Científico-Técnica; 1986, pp 66-7.