Intravenous anesthesia


Anesthesia and Pain Medicine. 2004 Dec. 8(4): 213-218
ⓒ Korean Society for Intravenous Anesthesia
Electrocardiographic Abnormalities after Subarchnoid Hemorrhage
Tae-Kwan Kim, M.D., and Min Kyu Lee, M.D.
Department of Anesthesiololgy and Pain Medicine, School of Medicine, The Catholic University of Korea, Bucheon, Korea

Background: Electrocardiographic abnormality both morphologic and rhythmic, are frequently seen in association with spontaneous subarachnoid hemorrhage (SAH). Although commonly considered functionally insignificant neurogenic phenomena, there are increasing evidences that these electrocardiogram (ECG) abnormalities are a sign of underlying cardiac pathology and dysfunction.
Methods: For this study, review the data from all patients admitted to NICU from October 2002 to March 2004 were rectrospectively analyzed. The data in this study included the patient dermographics, the frequency and type of cardiac arrhythmia, serum electrolyte Na , K , asparte transferase (AST), alanine aminotransferse (ALT) and cardiac enzyme relating with myocardial injury.
Results: ECG abnormalities occurred in 39 (54.9%) of 71 patients in the study cohort. The most frequent findings were rhythmic disturbance including sinus bradycardia, frequent premature ventricular contraction (PVC), sinus tachcardia were followed by T wave abnormality, ST segment abnormality, and QT prolngation. The total creatine phophokinase (CK) activity and serum CK-MB were within normal limits except for 12 patients who had elevated level but the isoenzyme, CK-MM type were idenitife d and troponin level were less than 0.01 ng/ml. The Lactic dehydrogenase (LDH) also were within normal limits.
Conclusions: Most of the ECG abnormalities in SAH patients are neurogenic rather than cardiogenic origin but in others ventricular dysfunction and other pathologic conditions can occur. Therefore in suspicious cases, preanesthetic cardiac assessment in patients with ECG abnormalities is needed but the decision to operation should not be influenced by these ECG changes.
Key words : Brain, subarchnoid hemorrhage, mornitoring, electrocardiogram
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