[Cerebrogenic ECG changes after severe subarachnoid hemorrhage from an internal carotid artery aneurysm--differential diagnosis of acute myocardial infarct].
ECG-changes simulating acute posterior myocardial infarction were observed in a 62-year-old woman 16 days after acute subarachnoid hemorrhage. An acute myocardial ischemia was excluded by enzyme laboratory tests and by coronary angiography. The transient ECG-changes can be explained by short-term spasms of small distal arterioles in the heart, which were affected by a derangement of autonomic function. The present case demonstrates ECG-changes in a patient with subarachnoid hemorrhage very late after the acute event. Therefore, patients with intracranial hemorrhage should have a prolonged electrocardiographical aftercare. ECG-changes in patients with subarachnoid hemorrhage were discussed as a specific parameter describing the degree of intracranial damage and as a predictive value for a poor outcome. Because of ventricular arrhythmias and the occurrence of sudden cardiac death in patients with subarachnoid hemorrhage critical care monitoring should be performed after detection of new ECG-changes.
Hagendorff
A
A
Medizinische Universittsklinik, Bonn.
Pavlidis
C
C
Jung
W
W
Lüderitz
B
B
D001341:Autonomic Nervous System / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000503:physiopathology; D002343:Carotid Artery, Internal; D002533:Cerebral Angiography; D003422:Critical Care; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D003937:Diagnosis, Differential; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006321:Heart / Q000294:innervation; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000503:physiopathology; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology