Evaluation of Cardiac Manifestations in Acute Haemorrhagic Stroke Patients

Introduction: Stroke remains a major cause of death, disability and socioeconomic burden worldwide. Although neurological injury is the primary clinical concern, acute haemorrhagic stroke can also produce important cardiovascular manifestations through autonomic dysfunction, catecholamine excess, pre-existing cardiovascular disease and direct neurocardiac interactions. These abnormalities may include electrocardiographic changes, arrhythmias, myocardial injury, left ventricular dysfunction and structural cardiac abnormalities. Early recognition may therefore assist risk stratification and clinical management. Objective: To evaluate the cardiac manifestations and associated risk factors in acute haemorrhagic stroke patients. Methods: This prospective cross-sectional observational study was conducted in the Departments of Medicine and Neurology, Khulna Medical College Hospital. A total of 50 patients with acute haemorrhagic stroke were included. Electrocardiography and two-dimensional echocardiography were performed within 24 hours of hospital admission. Demographic characteristics, vascular risk factors, ECG abnormalities, echocardiographic abnormalities and in-hospital outcomes were evaluated. Results: The mean age of the participants was 62.05 ± 9.87 years, with male-to-female ratio of 1.77:1. ECG abnormalities were identified in 74.0% of patients and echocardiographic abnormalities in 58.0%. QTc prolongation was the most frequent ECG abnormality (46.0%), followed by ST-segment depression (40.0%), U waves (32.0%), T-wave inversion (32.0%) and electrocardiographic left ventricular hypertrophy (30.0%). Echocardiography showed diastolic dysfunction in 48.0%, left ventricular hypertrophy in 36.0%, mitral regurgitation in 24.0%, aortic valve calcification in 22.0%, regional wall-motion abnormality in 12.0%, left ventricular systolic dysfunction in 10.0%, aortic regurgitation in 8.0% and left ventricular dilatation in 6.0%. Conclusion: Cardiac abnormalities were highly prevalent among patients admitted with acute haemorrhagic stroke. Early ECG assessment and echocardiography may therefore provide clinically useful information for identifying high-risk haemorrhagic-stroke patients. Medicine Today 2026, Vol.38 (2): 232-236