Neurologic Insult ECG Review

Most commonly seen in the setting of acute stroke (CVA), intracranial hemorrhage, subarachnoid hemorrhage, or after carotid endarterectomy, neurologic injury can result in the following ECG changes:

1. Diffuse deeply inverted T waves
2. Prolonged QT interval

These changes may mimic ischemia. There is debate regarding the risk of the prolonged QT interval leading to polymorphic ventricular tachycardia in this setting.

ECG Examples:

• Neurologic Insult ECG Example 1
• Neurologic Insult ECG Example 2

• Neurologic Insult ECG Example 3

References:

1. Surawicz B et al. ACC/AHA recommendations for the standardization and interpretation of the electrocardiogram. Circulation. 2009;119:e235-240.

2. Chou's Electrocardiography in Clinical Practice: Adult and Pediatric, 6e

By Steven Lome