Abstract
In 1947, BYER et al. reported that the patient with cerebral disease present electrocardiographic abnormalities. This problem has aroused attention and since then a number of investigations concerning electrocardiographic changes in patients with cerebrovascular accidents have been reported though their mechanism remained still unsettled. The authors have also been interested on the subject because similar changes in electrocardiogram have been seen in number of patients with cerebrovascular accidents, accompanied with an increase in urinary excretion of catecholamines. The purpose of this paper is to present the electrocardiographic findings seen after cerebrovasclilar accidents with urinary excretion of catecholamines in connection with the mechanism. Material and Methods Among the patients who were admitted to the ward of Hospital of Kobe Medical College, during the period between 1960 and 1963, 19 patients with cerebrovascular accidents have been studied. These patients studied consisted of 4 groups ; namely, cerebral hemorrhage (7), subarachnoid hemorrhage (5), cerebral infarction (3), and transient cerebral ischemia with-out infarction (4). The electrocardiograms were recorded in the earliest hour after the onset of the cerebral stroke. They were taken within the first 24 hours in 5 patients, 24 to 72 hours in 6 patients and 4 to 14 days in the rest of the patients. Adrenaline and noradrenaline were deter-mined on 24-hour urine by the method which has been reported elsewhere. The measure-ments of the hormones were made once in 1 3 cases and repeatedly following the course in 6. Results The ages of the 19 patients, namely, 12 males and 7 females, ranged from 38 to 75 years, with an average of 60.3 years. Of the 19 patients, 12 were found to have clinical evidences of hypertension prior to admission to the hospital. Five died, and postmortem examinations were performed in three. One of the 3 had a cardiac enlargement of 500 gm but no visible evidence of myocardial infarction. No cardiac enlargement was found in the remaining 2. Electrocardiographic findings: The atrial fibrillation was noted in 3 patients; two had the multiple atrial ectopic beats. The ventricular ectopic beats were seen in one. The PQ prolongation was seen only in one patient.
