University of Basrah/Al-Zahraa college of medicine

ECG changes in ischemic stroke patients in Basrah & relationships with specific
risk factors of Ischemic stroke
A graduation Project for Partial Fulfillment of the Bachelor of Medicine & Bachelor
of Surgery degree
Done by:
Fatima Abedulkhalik Turkey
Muhammad Khairy Dafar
Mohammed Amjad Dawood
Mohammed Hamid Abd-alnabi
Majeed Yassin Majeed
Supervised by:
DR. Mohammad Adil Abd-Hassan
2023-2024 A. D 1445A.H
Dedication

"We dedicate this achievement to Allah Almighty, and to those who

have supported and encouraged us throughout this journey. To our
family, a constant source of inspiration and motivation, and to our
loyal friends who shared both the challenging and joyful moments. Our
heartfelt gratitude goes out to all of you. "
Acknowledgment

• "We express our deepest thanks to Dr. Mohammad Adil Abd-Hassan,

our supervisor, for his invaluable guidance and support in this project.

Our gratitude also goes to the hospital staff, whose friendliness and
cooperation were crucial to the study's success".
.
Meaning Abbreviation
Electrocardiography ECG
Computed Tomography CT
Cerebrovascular Accident CVA
Cerebrovascular Insult CVI
Atrial Fibrillation AF
Low-Density Lipoprotein LDL
Facial droop, Arm weakness, Speech difficulty, Time to call emergency services FAST
Chemokine (C-X-C Motif) Ligand 8 CXCL8
Chemokine (C-C Motif) Ligand 2 CCL2
Chemokine (C-C Motif) Ligand 3 CCL3
National Institute of Neurological Disorders and Stroke NIHSS
Magnetic Resonance Imaging MRI
Left Ventricular Hypertrophy LVH
Left Atrial Enlargement LAE
Diabetes Mellitus DM
Ischemic Heart Disease IHD
Left Bundle Branch Block LBBB
Aim of study

1. To find the common ECG Changes that develop in patients with acute
ischemic stroke
2. To determine if these risk factors are affected by the presence of
specific Risk factors of stroke.
 Methods and Materials:
This is a cross-sectional study conducted at the Neurology Center Ward
in Al Basrah Teaching Hospital from September 15, 2023, to November
1,2023. The study included a total of 107 patients with acute ischemic
stroke admitted within 48 hours of the onset of
neurological symptoms.
We verified the patients' age, gender, hypertension status, diabetic
mellitus, and previous diagnoses of ischemic heart disease and stroke
through consultation with their senior physicians and confirmation of
prescribed medications. The ECGs and CT scans were reviewed by senior
internal medicine specialists.
Result:
Baseline characteristics of patients
Percentage Number Parameter
100% 107 Total Patients
53.27% 57 Male
Gender
46.72% 50 Female
3.73% 4 < 40 yrs.

34.57% 37 40 – 60 yrs. Age

61.68% 66 > 60 yrs.

74.76% 80 Hypertension
45.79% 49 Diabetes Mellitus
36.44% 39 Previous CVA
33.64% 36 Previous IHD
23.36% 25 Smoking
• Table 2: Relationship between the age groups and ECG changes in
patients with ischemic strokeWith
No ECG Parameter
ECG ECG Changes NO ECG
Total
Changes TotalAge Nchanges
% N % N changes
%Below 40 1 25% 3 75% 4 3.73%40-60
pateints
<60
16 43.24% 21 56.75% 337 34.57%Above1 604 46 69.69%
yrs. 20 30.30% 66
61.68%Total 63 44 107 100%P VALUE =0.0.0121N=Number
40 – Age
21 16 37 60
%=Percentage yrs.
> 60
20 46 66
yrs.
Discussion
Limitations
1- number of patients may be small to represent the population.
2- some ECG changes may present as risk factors and complications,
especially AF and the patient may not be diagnosed before the stroke
state and history may not provide confirmed information about the
patient's state.
 Conclusion
From these results, we can suggest that these changes may reflect underlying
cardiac diseases especially that many of those patients detected had previous
history of cardiovascular diseases but also some studies show similar changes in
those with no primary cardiac diseases so it may reflect the neurogenic changes
that cause by stroke and regions of stroke which not studies in our research that
may associate with these cardiac changes and also changes in autonomic response
and sympathetic activity. it also may reflect an appearance of asymptomatic cardiac
ischemic changes especially that many risk factors of stroke share with risk factors
of coronary artery diseases. In conclusion, our findings highlight the multifaceted
nature of ECG changes in stroke patients, suggesting a complex interplay between
cardiac and neurogenic factors, as well as common risk factors for cardiovascular
diseases.