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ST段抬高与蛛网膜下腔出血的困境：一例病例报告及文献综述

Dilemma of ST-Segment Elevation and Subarachnoid Hemorrhage: A Case Report and Literature Review.

作者信息

Ghumman Ghulam Mujtaba, Aravapalli Nagabindhu, Salman Fnu, Taleb Mohammed, Ali Sohail S

机构信息

Cardiovascular Disease, Mercy Health - St. Vincent Medical Center, Toledo, USA.

Internal Medicine, Mercy Health - St. Vincent Medical Center, Toledo, USA.

出版信息

Cureus. 2024 Sep 30;16(9):e70564. doi: 10.7759/cureus.70564. eCollection 2024 Sep.

DOI:10.7759/cureus.70564
PMID:39483935
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11527479/
Abstract

Acute ST-segment elevation myocardial infarction (STEMI) occurs due to occlusion of one or more coronary arteries causing myocardial injury. It is a medical emergency and requires prompt diagnosis and intervention. Transient ST-segment elevation can occur due to coronary vasospasm, and their association has been reported with subarachnoid hemorrhage. We present a distinct case of ST-segment elevations in inferior leads with reciprocal ST-depressions in lateral leads, indicating STEMI that leads to complete heart block and ventricular fibrillation cardiac arrest in a patient with subarachnoid hemorrhage. The coronary angiogram was negative for any obstructive coronary artery disease.

摘要

急性ST段抬高型心肌梗死（STEMI）是由于一支或多支冠状动脉闭塞导致心肌损伤而发生的。它是一种医疗急症，需要迅速诊断和干预。冠状动脉痉挛可导致短暂性ST段抬高，并且已有报道其与蛛网膜下腔出血有关。我们报告了一例独特的病例，该病例下壁导联出现ST段抬高，侧壁导联出现对应性ST段压低，提示STEMI，导致一名蛛网膜下腔出血患者发生完全性心脏传导阻滞和心室颤动心脏骤停。冠状动脉造影显示无任何阻塞性冠状动脉疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/c55f22266e7d/cureus-0016-00000070564-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/ac57df86b8d4/cureus-0016-00000070564-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/73a6574a49ce/cureus-0016-00000070564-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/0298132ebf35/cureus-0016-00000070564-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/48681165a166/cureus-0016-00000070564-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/c55f22266e7d/cureus-0016-00000070564-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/ac57df86b8d4/cureus-0016-00000070564-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/73a6574a49ce/cureus-0016-00000070564-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/0298132ebf35/cureus-0016-00000070564-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/48681165a166/cureus-0016-00000070564-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6f/11527479/c55f22266e7d/cureus-0016-00000070564-i05.jpg

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本文引用的文献

1
Incidence and Outcomes of Registry-Based Acute Myocardial Infarction After Aneurysmal Subarachnoid Hemorrhage.基于注册的动脉瘤性蛛网膜下腔出血后急性心肌梗死的发生率和结局。
Neurocrit Care. 2022 Jun;36(3):772-780. doi: 10.1007/s12028-021-01365-3. Epub 2021 Oct 25.
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Impact of Acute Cardiac Complications After Subarachnoid Hemorrhage on Long-Term Mortality and Cardiovascular Events.蛛网膜下腔出血后急性心脏并发症对长期死亡率和心血管事件的影响。
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Concurrent subarachnoid haemorrhage and ST elevation myocardial infarction.
同时发生的蛛网膜下腔出血和ST段抬高型心肌梗死
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Clin Exp Emerg Med. 2015 Dec 28;2(4):260-263. doi: 10.15441/ceem.15.012. eCollection 2015 Dec.
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Clinical and cardiac features of patients with subarachnoid haemorrhage presenting with out-of-hospital cardiac arrest.蛛网膜下腔出血患者院外心脏骤停的临床和心脏特征。
Resuscitation. 2011 Oct;82(10):1294-7. doi: 10.1016/j.resuscitation.2011.05.019. Epub 2011 Jul 20.
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