ECG changes of cardiac origin in elderly patients with traumatic brain injury

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.

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.

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.

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.