Naslov
Cardiac death due to the stroke registered on 24h ECG Holter

Autori
Car, Antun

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, prošireni sažetak, znanstveni

Izvornik
Cardiologia Croatica. 2022 ; 17(9-10):149-368. / - , 2022, 219-219

Skup
14. kongres Hrvatskoga kardiološkog društva s međunarodnim sudjelovanjem. 14th Congress of the Croatian Cardiac Society with International Participation.

Mjesto i datum
Zagreb, Hrvatska, 24.-27.11.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
24h ECG Holter, ischemic stroke, cardiac arrhythmias, death

Sažetak
Cardiac death due to the stroke registered on 24h ECG Holter Case report This case report focuses on cardiac dysfunction and death during 24h ECG Holter monitoring in the setting of ischemic stroke of the 73 old male hypertensive patient. His ECG was without sings of ischemic cardiac disease on admission. There were no laboratory tests positive for acute myocardial ischemia. MSCT of the brain showed hyper density of the ACM of the right side and hypo density of the irrigation of the right ACM of the right hemisphere of the brain. The patient has been checked by cardiologist two days before the death. He was in sinus rhythm, without signs of myocardial ischemia, treated with antiedematous therapy by neurologist. Because of the ischemic brain changes in the right ACM, thrombolytic therapy could not be used. LMWH and parenteral antihypertensive therapy has been used and rehydration of the patient. During the continuous 24h ECG Holter monitoring during 21.54 h (until the moment of death) registered 89 364 cardiac cycles. It was sinus rhythm from 8 o’clock till to 8.47 pm when one short period of atrial fibrillation appeared. After reaching the sinus rhythm again, appeared salves of VES (up to 4 VES). Finally there was appearance of the new RBBB, which was followed by slow ventricular tachycardia which ended in Brady arrhythmia, asystole and death. Death came during the 24 h Holter monitoring due to the grave ischemic acute insult of the right cerebral hemisphere. This case report proves that patients with the right stroke have different arrhythmic disturbances due to the cerebral ischemia. The risk of cardiac complications increases proportionally to the severity of ischemic stroke and neurologic deficit. Approximately 67% of acute ischemic stroke patients have ECG abnormalities of ischemic, and arrhythmic in the first 24 h after stroke. Cardiac arrhythmias are common reasons for death after acute ischemic stroke. Sympathetic hyperactivity and decrease in parasympathetic activity caused by stroke may be the reason of arrhythmia and sudden death. At the patients with the terminal no cardiac disease final cause of the death was confirmed to be bradyarrhythmia in 87% of the patients and ventricular tachyarrhythmia in 17%. Agonal ST elevation was observed. In our case, there was also agonal ST elevation. Death was due to the bradyarrhythmia. Incidence of sudden death in the course of acute stroke ranging from 2% to 6%. Keywords: 24h ECG Holter, ischemic stroke, cardiac arrhythmias, death.

Izvorni jezik
Engleski

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