title: Diagnosis of subarachnoid hemorrhage indicated by transthoracic echocardiography.
abstract: We report the case of a 63-year-old woman who presented to her local emergency department unresponsive and in a state of cardiogenic shock 4 hours after the sudden onset of a severe headache. Her electrocardiogram revealed nonprogressive 1-mm S-T elevation in leads V(5) to V(6) and a prolonged QTc. A transthoracic echocardiogram performed at the time of her resuscitation revealed regional wall-motion abnormalities not consistent with any known coronary artery territory but consistent with a diagnosis of acute subarachnoid hemorrhage. This diagnosis was subsequently confirmed on computed tomography brain imaging. Although subarachnoid hemorrhage is known to be associated with cardiopulmonary dysfunction, and electrocardiogram and echocardiogram abnormalities, the diagnosis of subarachnoid hemorrhage suspected by echocardiography before brain imaging has not previously been described.
authors.affiliation: Department of Cardiovascular Medicine, Northwick Park Hospital.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Birns
authors.forename: Nikant
authors.initials: N
authors.lastname: Sabharwal
authors.forename: Roxy
authors.initials: R
authors.lastname: Senior
mesh_terms: D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000175:diagnosis; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed