Gerges Mina, Bathobakae Lefika, Mahmoud Anas, Saad Remon, Elkattawy Sherif, Shamoon Fayez, Ismail Mourad
Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.
Cardiology Division, St. Joseph's University Medical Center, Paterson, USA.
Eur J Case Rep Intern Med. 2024 Jul 4;11(8):004713. doi: 10.12890/2024_004713. eCollection 2024.
Subarachnoid haemorrhage (SAH) is a rare yet consequential medical emergency that may mimic an acute myocardial infarction (MI). SAH causes enhanced sympathetic activity, culminating in the development of neurogenic stunned myocardium (NSM), which presents as ST-segment deviations, prolonged QT intervals, T-wave inversions or Q-waves. Reperfusion therapy is contraindicated for SAH because of an increased risk of bleeding and death. Therefore, a prompt diagnosis is crucial. Here, we report a unique case of massive SAH presenting as diffuse ST-segment deviation simulating an acute MI. Our patient was brought to the emergency department after a cardiac arrest and died on day 2 of admission.
Subarachnoid haemorrhage (SAH) can present with EKG changes and significant rise in troponin, mimicking acute coronary syndrome.SAH should be included in the differential diagnosis for patients presenting with neurological symptoms, ST-segment deviations or prolonged QT intervals.Misdiagnosis of SAH as acute coronary syndrome can lead to inappropriate use of anticoagulants or delays in necessary neurological interventions.
蛛网膜下腔出血（SAH）是一种罕见但后果严重的医疗急症，可能酷似急性心肌梗死（MI）。SAH会导致交感神经活动增强，最终发展为神经源性心肌顿抑（NSM），表现为ST段偏移、QT间期延长、T波倒置或Q波。由于出血和死亡风险增加，再灌注治疗对SAH是禁忌的。因此，快速诊断至关重要。在此，我们报告一例独特的大量SAH病例，表现为弥漫性ST段偏移，酷似急性心肌梗死。我们的患者在心脏骤停后被送往急诊科，并于入院第2天死亡。
蛛网膜下腔出血（SAH）可出现心电图改变和肌钙蛋白显著升高，酷似急性冠状动脉综合征。对于出现神经症状、ST段偏移或QT间期延长的患者，SAH应列入鉴别诊断。将SAH误诊为急性冠状动脉综合征可能导致抗凝剂使用不当或必要的神经干预延迟。
