Aziz Ezzat Mohammed Hussain, Alhatemi Ahmed Qasim Mohammed, Hashim Hashim Talib, Khaleel Amir Salam
Coronary Care Unit, Al Nasiriyah Heart Hospital, Thi Qar 64001, Iraq.
Department of Internal Medicine, Al Nasiriyah Teaching Hospital, Thi Qar 64001, Iraq.
Oxf Med Case Reports. 2024 Dec 28;2024(12):omae154. doi: 10.1093/omcr/omae154. eCollection 2024 Dec.
We present a case detailing the diagnostic challenges of a 23-year-old male presenting with a sudden severe headache, nausea, vomiting, and chest heaviness. Initial evaluation showed elevated blood pressure and respiratory rate. An emergency electrocardiogram (ECG) indicated ST-segment elevation myocardial infarction (STEMI), leading to immediate referral for percutaneous coronary intervention, which revealed normal coronary arteries. Further investigations identified a cisternal subarachnoid haemorrhage (SAH) on CT brain imaging. Despite multidisciplinary management, the patient's condition rapidly deteriorated, resulting in cardiac arrest and mortality. Our case highlights the importance of thorough evaluation and multidisciplinary collaboration in managing complex presentations, emphasizing vigilance in recognizing and managing concurrent pathologies in young patients with acute symptoms.
我们报告一例病例，详细介绍了一名23岁男性患者所面临的诊断挑战，该患者出现突发剧烈头痛、恶心、呕吐及胸部闷痛症状。初始评估显示血压和呼吸频率升高。紧急心电图（ECG）提示ST段抬高型心肌梗死（STEMI），遂立即转诊进行经皮冠状动脉介入治疗，结果显示冠状动脉正常。进一步检查在脑部CT成像中发现脑池蛛网膜下腔出血（SAH）。尽管采取了多学科管理措施，但患者病情迅速恶化，最终心脏骤停并死亡。我们的病例强调了在处理复杂病情时进行全面评估和多学科协作的重要性，强调在识别和处理有急性症状的年轻患者并发疾病时要保持警惕。
