The prevalence of ecg abnormalities and abnormal troponin t levels in patients with non-traumatic sub-arachnoid haemorrhage

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.