European Journal of Molecular & Clinical Medicine

Background: Rheumatoid arthritis (RA) is a chronic multi system disease of unknown cause. The most frequent site of cardiac involvement in RA is the pericardium.  Cardiac disease is clinically silent and is rarely a life-threatening complication in RA. Cardiac failure is the result of either systolic or diastolic dysfunction, or both. Hence this study was conducted to study correlation of electrocardiographic abnormalities and echocardiographic findings in rheumatoid arthritis patients without clinically evident cardiovascular manifestations with the duration of disease.
Methodology: The Hospital based cross sectional observational study was conducted on 50 patients, above 20 years attending the medicine outpatient department of Dr. S.N. Medical College and Mathura Das Mathur Hospital Jodhpur with an established diagnosis of RA, as defined by the ACR/EULAR criteria for Rheumatoid arthritis. A questionnaire was prepared and investigations were performed.
Results: Cardiovascular manifestations are common in Rheumatoid arthritis patients. This study highlights the need for systematic electrocardiogram in patients with rheumatoid arthritis, even in the early stages of the disease when cardiovascular involvement is clinically silent because electrocardiographic abnormalities are real and should alarm the physician and lead to the initiation of appropriate therapy that may help reduce the incidence of cardiovascular death in RA patients. The relation between transmitral flow alteration and disease duration suggests a sub-clinical myocardial involvement with disease progression and may be related to the high incidence of cardiovascular deaths in patients with RA

Background: The annual incidence of intra cerebral hemorrhage (ICH) is 25 cases per 1, 00,000/year. Although ECG abnormalities are well known in ischemic stroke and subarachnoid hemorrhage these change have been rarely been investigated systematically in patients with ICH. Present study was aimed to study any association between ECG changes to the Site of Bleed (SOB) in non-traumatic spontaneous intracerebral hemorrhage (ICH). Material and Methods: Present study was a prospective, observational study, conducted in patients confirmed of ICH on CT scan. Each case was examined in detail with history, clinical features, ECG readings & CT scan findings.
Results: In present study, male to female ratio was 1.7:1. Maximum number of patients were from > 60 years age (52%). The various CT scan findings noted in the study were < 50 cc volume of hematoma (52%), presence of mass effect (40%) & presence of intra ventricular communication (38%). The most common site of bleeding was putamen (40%) followed by thalamus (30%), lobar (14%), brainstem (10%) & cerebellum (6%). The most common ECG findings in our study were Left Ventricular hypertrophy (56%) followed by prolonged QTc (54%), T wave inversion (56%), Left axis deviation (46%), Tachycardia (36%), ST-T changes (28%), Q waves (22%), Tall T wave (8%), VPC (8%) and RBBB changes (8%). In present study, there was statistically significant association was noted between LAD, IVC and LVH with ECG changes (p<0.05).
Conclusion: Significant association could not be established between specific site of bleed and ECG changes even though the proportions ECG changes to Site of bleed was significant.