The Great Mimicker: A Unique Case of Diffuse Subarachnoid Haemorrhage Simulating Acute Myocardial Infarction.
Eur J Case Rep Intern Med
; 11(8): 004713, 2024.
Article
in En
| MEDLINE
| ID: mdl-39130074
ABSTRACT
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. LEARNING POINTS 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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Eur J Case Rep Intern Med
Year:
2024
Document type:
Article
Affiliation country:
United States
Country of publication:
Italy