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Ecg Changes of Cardiac Origin in Elderly Patients With Traumatic Brain Injury



Hashemian AM1 ; Ahmadi K2 ; Taherinia A2 ; Sharifi MD1 ; Ramezani J3 ; Jazayeri SB4 ; Saadat S4 ; Rahimimovaghar V4
Authors
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Authors Affiliations
  1. 1. Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  2. 2. Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran
  3. 3. Department of cardiology, Mashhad University of medical sciences, Mashhad, Iran
  4. 4. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Medical Journal of the Islamic Republic of Iran Published:2015

Abstract

Background: Simultaneous electrocardiographic (ECG) changes are seen in hemorrhagic brain events even in the absence of associated myocardial infarction (MI). This study was designed to assess the role of ECG changes to predict true MI in patients with hemorrhagic brain trauma. Methods: Data of 153 patients with traumatic brain injury and concomitant ECG changes were recorded. Enzyme study was performed for the patients, and a cardiologist confirmed the diagnosis of MI. Results: Overall, 83 females and 70 males older than 50 years of age were enrolled in the study. The most common type of hemorrhagic brain event was subarachnoid hemorrhage, and the most common ECG change was an inverted T wave. MI was confirmed in 15 (9.8%) patients. Patients with intracranial hemorrhage had significantly (p= 0.023) higher rates of associated MI than other types of brain hemorrhages. ST segment elevation was found to have a positive predictive value of 71.4% in males and 25% in females in terms of diagnosing a true MI associated with hemorrhagic brain events. Conclusion: Although simultaneous cardiac changes are seen after sympathetic over- activity in brain hemorrhages, regular ECG screening of elder patients with traumatic brain injury is suggested, particularly in patients with intracranial hemorrhages.