Cardiovascular effects of acute stroke.

A wide variety of dysrhythmias, conduction defects, and repolarization abnormalities have been observed following all types of stroke, most likely related to disruptions in the autonomic nervous system. Patients at highest risk for developing ECG changes include those with hemorrhagic stroke, those with strokes involving the right cerebral hemisphere, and elderly patients with stroke. Nursing interventions for these patients revolve around vigilant monitoring of both neurologic and cardiovascular status, to identify any negative consequences from the interaction of these systems. Strict blood pressure monitoring is required, with different management goals depending upon the type of stroke. Also important is the prevention of further exacerbation of ECG abnormalities by maintaining normal electrolyte levels.