The prevalence of ecg abnormalities and abnormal troponin t levels in patients with non-traumatic sub-arachnoid haemorrhage
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Date
2020
Authors
Nash, Samantha Anne
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Abstract
In this prospective study, electrocardiogram (ECG) and high sensitivity Troponin-T (hs-cTnT) levels were evaluated in patients presenting to Chris Hani Baragwanath Academic Hospital (CHBAH) Neurosurgical department with non-traumatic sub-arachnoid haemorrhage (SAH). ECG changes are well recognised in world literature, in patients with non-traumatic SAH. To the authors knowledge, this has never been investigated in South African patients. Thirty-two patients met the inclusion criteria out of a total of 40 patients. ECG and serum hs-cTnT levels were done within 7 days of onset of initial symptoms. hs-cTnT levels were stratified as normal (<15 ng/L), positive (15-100 ng/L) and high positive (>100 ng/L).
59.38% of patients in this study were female and 40.63% male, and 65.63% of patients fell between the ages of 41-60 years of age. 46.88% of patients had a World Federation of Neurological Societies(WFNS) grade of 1 or 2 as per the WFNS grading of SAH while 9.38% and 31.25% of patients were a WFNS grade 3 and grade 4 respectively.The most common Computed Tomography of Brain (CTB) finding was Intraventricular haemorrhage (IVH). The cause of SAH was secondary to ruptured aneurysm in 81.25% of patients. 56.25% of all participants had an elevated serum hs-cTnT (total of positive and high positive categories) level whereas 87.5% of all participants had ECG changes. With regards to specific ECG abnormalities, the most common changes found were ST, T wave and QTc interval changes. This research project shows that the prevalence of ECG abnormalities in a patient population attending CHBAH are in keeping with international literature. In this study we had a higher prevalence of raised hs-cTnT levels which may be due to increased underlying cardiac co-morbidity in the study population, late sample collection times, or result cut points being too low amongst others . A further study could be performed to evaluate whether ECG changes or raised hs-cTnT levels denote a poorer prognosis in patients with SAH.
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A research report submitted in partial fulfilment of the requirements for the Degree of Master of Medicine in the branch of Neurosurgery to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020