title: A case of subarachnoid hemorrhage revealed by an acute coronary syndrome (ACS).
abstract: The subarachnoid hemorrhage (SAH) is definitely the best descriptive model of the interaction between cardiovascular system and cerebral damage. The underlying mechanism of cardiovascular alterations after SAH is linked to the adrenergic discharge related to aneurysm rupture. Cardiac and pulmonary complications are common after severe brain injury, especially the aneurismal subarachnoid hemorrhage. Acute neurogenic pulmonary edema is not exceptional; it may occur in 20% of cases and commonly follows a severe subarachnoid hemorrhage. Severe myocardial damage with cardiogenic shock may possibly reveal the SAH (3% of cases) and mislead to wrong diagnosis of ACS with dramatic therapeutic consequences. The contribution of CT and cerebral angiography is essential for diagnosis and treatment. Surgical or endovascular treatment depends on location, size and shape of the aneurysm, on patient's age, neurological status and existence of concomitant diseases. We report the case of a 58 years old patient, with a past medical history of diabetes and hypertension, admitted for acute pulmonary edema with cardiogenic shock. This case illustrates an unusual presentation of aneurismal SAH in a patient presenting with an acute coronary syndrome.
authors: Cardiovascular Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
authors: Abdedaim
authors: A
authors: Hatim
authors: Cardiovascular Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
authors: Wafae
authors: W
authors: El Otmani
authors: Cardiovascular Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
authors: Mehdi Ait
authors: MA
authors: Houssa
authors: Cardiovascular Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
authors: Noureddine
authors: N
authors: Atmani
authors: Cardiovascular Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
authors: Younes
authors: Y
authors: Moutakiallah
authors: Medical Intensive Care Department, Military Hospital Mohammed V, Rabat, Morocco.
authors: Charqui
authors: C
authors: Haimeur
authors: Cardiovascular Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
authors: Mohammed
authors: M
authors: Drissi
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000473:pathology; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000473:pathology
keywords: Subarachnoid hemorrhage; acute coronary syndrome; acute neurogenic pulmonary edema; cardiogenic shock; catecholamine discharge