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  • Küçük Resim
    Öğe
    Analysis of acute stroke patients admitted to the emergency department
    (2018) Avci, Mustafa; Atik, Ismail; Kesapli, Mustafa; Ararat, Ertan
    Aim: In this study we investigated the demographics and medical characteristics of acute stroke patients who applied to emergency department (ED) and were admitted to neurology department (ND). Material and Methods: This study was conducted in a tertiary hospital. The patients’ medical records were reviewed; age, gender, diagnosis, comorbid diseases, previously anticoagulant treatment, brain computerized tomography reports, brain magnetic resonance imaging reports, hospitalized unit, length of hospital stay, vitamin B12 levels, electrocardiography recordings, and the outcome of patients. Results: In the including time of the study, 523 patients were hospitalized to the ND from ED. The patients with cerebrovascular diseases (CVD) were 68.7% (n=357) of the hospitalized patients. The patients with acute ischemic stroke (AIS) were 74.8 % (n=267) of the patients with CVD. In AIS, the most common comorbid disease was hypertension, followed by atrial fibrillation (AF). The rate of AF was 31% in AIS. AF was newly diagnosed in 46% (38 patients) of patients with AIS, and these patients had no anticoagulation therapy. Vitamin B12 levels were found to be low in 58 (21.7%) of AIS patients. Conclusion: A large number of patients with undiagnosed AF are diagnosed following AIS. Therefore, it is important that these patients should be followed closely for AF and its management, and it is also important to treat vitamin B12 deficiency to prevent stroke development.
  • Küçük Resim
    Öğe
    Fragmented QRS; as a new sign on ECG for pre-diagnosis of non-ST elevation myocardial infarction
    (2018) Ararat, Ertan; Kozaci, Nalan; Avci, Mustafa; Koklu, Erkan
    Aim: The aim of this study is to evaluate the predictive value of fragmented QRS (fQRS) wave to detect non-ST elevation myocardial infarction (Non-STEMI). Material and Methods: The study included patients who were diagnosed with Non-STEMI in emergency department and underwent percutaneous coronary intervention in the cardiology clinic. Coronary artery circulation is anatomically divided as the left anterior descending coronary artery (LAD) (V1-V5), the left Circumflex (LCx) (I, aVL and V5,V6) and the right coronary artery (RCA) (II, III and aVF). Results: Our study included 191 patients. Significant fQRS was detected in 139 (%73) patients and ST/T was detected in 79 (%41) patients. The sensitivity, specificity, of fQRS in the inferior leads to predict RCA lesionwas 76%, 46%, respectively. The sensitivity, specificity, of ST/T in the inferior leads to “predict RCA lesion was 12%, 93%, respectively. The sensitivity, specificity of fQRS in the lateral leads to predict LCx lesion were 44% and 83%, respectively. The sensitivity, specificity of ST/T in the lateral leads to predict LCx lesion were 34%, 74%, respectively. The sensitivity, specificity of fQRS in the anterior leads to predict left LAD lesion were 34% and 82%, respectively. The sensitivity, specificity of ST/T in the anterior leads to predict LAD lesion were 38%, and 81%, respectively. Conclusion: We have compared to fQRS and ST/T on ECG; fQRS has higher sensitivity than ST/T to predict culprit coronary artery lesion. Therefore, evaluation of fQRS in addition to ST/T on ECG may be more valuable in pre-diagnosis of Non-STEMI.