Electrocardiographic changes in meningitis

Typical ECG changes were observed in 23 (74%) of 31 patients, aged 15 to 44 yr, with acute meningitis but without evidence of preexisting cardiovascular disease or electrolyte disturbances. The most frequent ECG abnormality was notching of the T wave in the precordial leads. This was observed in 17 patients (55%), a frequency significantly higher than that in the 2 control groups. Only 4 of 100 normal young adults and 5 of 60 young patients with pneumonia exhibited similar changes. Other, less common, changes in patients with meningitis were sinus bradycardia in 3 patients, atrioventricular dissociation in 1 patient, and transient diffuse ST elevations without any clinical evidence of pericarditis in 4 patients. ECG abnormalities were more common in patients with bacterial meningitis (15 of 16 patients) than in those with viral or aseptic meningitis (8 of 15). There was no correlation between ECG changes and cerebrospinal fluid pressure. The observations indicate that changes in the ECG in general and notching of the T waves in particular are common findings in meningitis.