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Abstract: Poster Presentations |

PATIENTS WITH ISCHEMIC STROKE HAVE A HIGHER PREVALENCE OF ABNORMAL PLANAR QRS-T ANGLE THAN PATIENTS WITH TRANSIENT ISCHEMIC ATTACK FREE TO VIEW

Kaushang Gandhi, MD*; Wilbert S. Aronow; Chandrasekar Palaniswamy, MD; Harshad Amin, MD; Harit Desai, MD; Hoang M. Lai, MD
Author and Funding Information

New York Medical College, Valhalla, NY


Chest


Chest. 2009;136(4_MeetingAbstracts):102S. doi:10.1378/chest.136.4_MeetingAbstracts.102S-a
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Abstract

PURPOSE:  Since ischemic stroke may be associated with autonomic imbalance which may affect cardiac repolarization, we investigated the prevalence of an abnormal planar QRS-T angle measured from a 12-lead electrocardiogram (ECG) in patients seen in the emergency department with an ischemic stroke versus a transient ischemic attack (TIA).

METHODS:  we investigated the prevalence of an abnormal planar QRS-T angle measured from a 12-lead ECG in 249 consecutive patients seen in the emergency department with focal neurological symptoms and signs in whom cerebral hemorrhage was excluded by a computer tomography brain scan. TIA was diagnosed if the focal neurological deficit lasted less than 24 hours. Ischemic stroke was confirmed by the computer tomography brain scan.The planar QRS-T angle was calculated by the difference between the QRS axis and the T wave axis on the 12-lead ECG. A QRS-T angle of > 90 degrees was considered abnormal.

RESULTS:  Of 249 patients, 175 (70%) had an ischemic stroke, and 74 (30%) had a TIA. The mean age was 68 years in patients with an ischemic stroke versus 61 years in patients with a TIA (p = 0.003). The prevalence of gender, race, hypertension, smoking, diabetes, dyslipidemia, obesity, and prior coronary artery disease was not significantly different between patients with an ischemic stroke versus a TIA. An abnormal planar QRS-T angle was present in 48 of 175 patients (27%) with an ischemic stroke versus in 8 of 74 patients (11%) with a TIA (p = 0.004).

CONCLUSION:  Patients with an ischemic stroke have a higher prevalence of an abnormal planar QRS-T angle on a 12-lead ECG than patients with a TIA.

CLINICAL IMPLICATIONS:  In patients being evaluated for ischemic stroke, a planar QRS-T angle should be measured from the 12-lead ECG obtained to rule out myocardial infarction.

DISCLOSURE:  Kaushang Gandhi, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM


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