Department of Internal Medicine, Kangbuk Samsung Medical Center, Seoul, Korea.
Korean Circ J. 2012 Mar;42(3):216-9. doi: 10.4070/kcj.2012.42.3.216. Epub 2012 Mar 26.
Without significant coronary artery stenosis, ischemic electrocardiographic change including ST segment elevation, segmental wall motion abnormality and elevated serum cardiac-specific markers (creatine kinase-MB, Troponin-T) may develop after central nervous system injuries such as subarachnoid, intracranial or subdural hemorrhage. Misdiagnosing these patients as acute myocardial infarction may result in catastrophic outcomes. By reporting a case of a 55-year old female with subarachnoid hemorrhage mimicking acute ST elevation myocardial infarction, we hope to underline that careful attention of neurologic abnormality is critical in making better prognosis.
在没有明显冠状动脉狭窄的情况下,中枢神经系统损伤(如蛛网膜下腔出血、颅内或硬脑膜下出血)后可能会出现缺血性心电图改变,包括 ST 段抬高、节段性壁运动异常和血清心脏特异性标志物(肌酸激酶-MB、肌钙蛋白-T)升高。将这些患者误诊为急性心肌梗死可能会导致灾难性后果。通过报告一例 55 岁女性蛛网膜下腔出血模拟急性 ST 段抬高型心肌梗死的病例,我们希望强调在做出更好预后时,仔细注意神经系统异常是至关重要的。