The Great Mimicker: A Unique Case of Diffuse Subarachnoid Haemorrhage Simulating Acute Myocardial Infarction.

ST-segment depression acute myocardial infarction electrocardiogram neurogenic stunned myocardium subarachnoid haemorrhage

Journal

European journal of case reports in internal medicine
ISSN: 2284-2594
Titre abrégé: Eur J Case Rep Intern Med
Pays: Italy
ID NLM: 101648453

Informations de publication

Date de publication:
2024
Historique:
received: 19 06 2024
accepted: 24 06 2024
medline: 12 8 2024
pubmed: 12 8 2024
entrez: 12 8 2024
Statut: epublish

Résumé

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.

Identifiants

pubmed: 39130074
doi: 10.12890/2024_004713
pii: 4713
pmc: PMC11313106
doi:

Types de publication

Journal Article

Langues

eng

Pagination

004713

Informations de copyright

© EFIM 2024.

Déclaration de conflit d'intérêts

Conflicts of Interests: The Authors declare that there are no competing interests.

Auteurs

Mina Gerges (M)

Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.

Lefika Bathobakae (L)

Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.

Anas Mahmoud (A)

Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.

Remon Saad (R)

Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.

Sherif Elkattawy (S)

Cardiology Division, St. Joseph's University Medical Center, Paterson, USA.

Fayez Shamoon (F)

Cardiology Division, St. Joseph's University Medical Center, Paterson, USA.

Mourad Ismail (M)

Pulmonary and Critical Care Medicine, St. Joseph's University Medical Center, Paterson, USA.

Classifications MeSH