title: [The brain as master of the heart].
abstract: We admitted a 42 year old woman with clinical signs of shock, coma, and ecg changes consistent with a ST elevation myocardial infarction to percutaneous coronary intervention. Normal coronary arteries were found. Due to the comatose state a cranial computed tomography scan was performed, where a subarachnoid hemorrhage was detected. We discuss the difficulty of diagnosing a subarachnoid hemorrhage, the pathophysiological cause of cardiac damage and ecg changes in acute neurological disease, and the differential diagnosis of ST elevation in the ecg.
authors.affiliation: Medizinische Klinik, Stadtspital Waid, Zürich.
authors.forename: Simon A
authors.initials: SA
authors.lastname: Müggler
authors.forename: Tina J
authors.initials: TJ
authors.lastname: Köhn
authors.forename: Stefan
authors.initials: S
authors.lastname: Christen
authors.forename: Christoph
authors.initials: C
authors.lastname: Schreen
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D001921:Brain / Q000503:physiopathology*; D002303:Cardiac Output, Low / Q000175:diagnosis / Q000503:physiopathology; D002533:Cerebral Angiography; D017023:Coronary Angiography; D003951:Diagnostic Errors; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology*; D004562:Electrocardiography; D004621:Embolization, Therapeutic; D005260:Female; D006321:Heart / Q000294:innervation*; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000503:physiopathology*; D012815:Signal Processing, Computer-Assisted; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology