Stress cardiomyopathy misinterpreted as ST-segment elevation myocardial infarction in a patient with aneurysmal subarachnoid hemorrhage: a case report

• DOI: 10.2478/rjim-2020-0010
• Publication Date: 2020-05-26T14:29:56Z
• Authors: Iulian Enache; Răzvan Alexandru ...; Elena Oana Terecoasă; Bogdan Dorobăţ; Cristina Tiu
• Keywords: ST elevation

Abstract Cardiac abnormalities are frequently reported in acute subarachnoid hemorrhage (SAH) patients. However, frank ST-elevation and myocardial dysfunction mimicking coronary syndrome is a rare occurrence. Systemic local catecholamine release mediate injury may explain raised troponin levels, concordant regional wall motion systolic dysfunction. These findings can pose significant problem the setting where “time-is-muscle” paradigm rush clinicians towards “rule-in” diagnosis of infarction. We present case 60-year-old male who arrived at emergency department with loss consciousness, chest pain headache. His ECG showed precordial leads corresponding region dynamically elevated levels which supported Percutaneous intervention was attempted but found no hemodynamically lesions patient managed conservatively antithrombotic treatment. Further work-up for his headache led to aneurysmal SAH subsequent endovascular coiling. The discharged good clinical outcome. discuss potential catastrophic consequences interpreting neurologic stunning as STEMI. Use potent therapies, like bridging thrombolysis, this lead dismal consequences. Clinical history should still be carefully obtained era sensitive biomarkers.