Background: Cerebrovascular accidents (CVAs) are a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries. Electrocardiographic (ECG) abnormalities are frequently observed in stroke patients and may reflect neurocardiogenic disturbances or underlying cardiac comorbidities. Their potential utility as prognostic markers remains underexplored in resource-limited emergency settings. Objective: To determine the prognostic significance of ECG abnormalities in predicting in-hospital outcomes among patients presenting with acute CVA. Methods: A cross-sectional observational study was conducted at the emergency department of Sheikh Zayed Hospital, Rahim Yar Khan, Pakistan, from July to December 2023. A total of 202 adult patients clinically suspected of CVA underwent baseline ECG evaluation on admission. Specific ECG abnormalities—including P wave changes, QT prolongation, T wave inversion, bundle branch blocks, and axis deviations—were recorded. Outcomes were categorized as discharge, ICU admission, or in-hospital death. Associations between ECG findings and outcomes were analyzed using chi-square tests and odds ratios, with p65 and cumulative ECG risk features. Conclusion: Early ECG abnormalities—especially QT prolongation, P wave changes, and T wave inversion—are significant predictors of mortality in acute stroke and should be incorporated into early risk stratification protocols in emergency care.

Objectives: This study aims to compare differences in outcomes between ST -Elevation Myocardial Infarction (STEMI) patients based on the presence or absence of Standard Modifiable Cardiovascular Risk Factors (SMuRFs). Materials and Methods: This cross-sectional study was conducted in the Cardiology Department of a tertiary care hospital in Pakistan. Study participants were divided into two groups based on STEMI classification: SMuRF vs. SMuRF-less. Patient characteristics, ECG, angiographic, and echocardiographic data were collected. In-hospital outcomes and mortality within a 3-day hospital stay were evaluated. Statistical Package for Social Sciences (SPSS) was used to compare the prognosis of SMuRF vs. SMuRF-less patients Results: 150 patients were enrolled, with 113 (75.3%) in the SMuRF group and 37 (24.6%) in the SMuRF-less group. Younger patients (18–25 years) were more prevalent in the SMuRF-less group (66%). Inferior wall MI was more commonly associated with four risk factors than anterior wall MI (12.5% vs. 2.7%, p=0.021). In-hospital outcomes showed no significant differences between SMuRF and SMuRF-less patients, including heart failure (OR 0.973, 95% CI: 0.447–2.119), mitral regurgitation (OR 1.158, 95% CI: 0.291–4.613), heart block (OR 0.757, 95% CI: 0.082–6.99), recurrent infarction (OR 0.323, 95% CI: 0.071–1.469), and renal failure (OR 0.600, 95% CI: 0.068–5.307). No deaths were reported in either group. Conclusion: Our study highlighted the trend of patients without SMuRF and its association with a younger age group. IWMI was more commonly associated with four risk factors, and there was no difference in in-hospital outcomes between SMuRF and SMuRF-less patients.