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Case Reports
. 2024 Dec 28;2024(12):omae154.
doi: 10.1093/omcr/omae154. eCollection 2024 Dec.

Mimicking myocardial infarction: a subarachnoid haemorrhage case report

Ezzat Mohammed Hussain Aziz  1 , Ahmed Qasim Mohammed Alhatemi  2 , Hashim Talib Hashim  3 , Amir Salam Khaleel  1
Affiliations
Case Reports

Mimicking myocardial infarction: a subarachnoid haemorrhage case report

Ezzat Mohammed Hussain Aziz et al. Oxf Med Case Reports. .

Abstract

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.

Keywords: cardiology; diagnostic testing; neurology.

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Conflict of interest statement

No conflict of interest to declare.

Figures

Figure 1
Figure 1
Electrocardiogram (ECG) obtained in the emergency department demonstrating significant ST-segment elevation (>2 mm) in leads V2-V5, suggestive of anterior myocardial infarction.
Figure 2
Figure 2
(A) Coronary angiography in the left anterior oblique (LAO) view, illustrating a normal right coronary artery (RCA) as indicated by the red arrow. (B) Coronary angiography in the LAO caudal view, displaying normal left circumflex artery (LCX) (red arrow) and left anterior descending artery (LAD) (white arrow).
Figure 3
Figure 3
Post-angiography ECG showing a normal sinus rhythm accompanied by left ventricular hypertrophy (LVH).
Figure 4
Figure 4
Brain CT axial view showing cisternal SAH (red arrows) with extension anterior to the right temporal lobe (white arrows).
See this image and copyright information in PMC

References

    1. Hjalmarsson C, Oras J, Redfors B. A case of intracerebral hemorrhage and apical ballooning: an important differential diagnosis in ST-segment elevation. Int J Cardiol 2015;186:90–2. 10.1016/j.ijcard.2015.03.187. - DOI - PubMed
    1. Giraldo-Delgado MA, Zuluaga-Gómez M, González-Arroyave D. et al. . ST-segment elevation associated with intraparenchymal hemorrhage: a case report. Biomed Rep 2023;18:1–5. 10.3892/br.2023.1622. - DOI - PMC - PubMed
    1. Rusoja E, Singh A. Intracranial Hemorrhage presenting with ST-segment elevation and T-wave inversion concerning for acute myocardial infarction. Adv Emerg Nurs J 2023;45:217–21. 10.1097/TME.0000000000000471. - DOI - PubMed
    1. Kuroiwa T, Morita H, Tanabe H. et al. . Significance of ST segment elevation in electrocardiograms in patients with ruptured cerebral aneurysms. Acta Neurochir 1995;133:141–6. 10.1007/BF01420064. - DOI - PubMed
    1. Faghih-Jouybari M, Raof MT, Abdollahzade S. et al. . Mortality and morbidity in patients with spontaneous intracerebral hemorrhage: a single-center experience. Curr J Neurol 2021;20:32–6. 10.18502/cjn.v20i1.6377. - DOI - PMC - PubMed

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