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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.

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/ac57df86b8d4/cureus-0016-00000070564-i01.jpg

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