Korean J Med.  1998 Nov;55(5):951-955.

Primary intracranial hemorrhage presenting as acute myocardial ischemic syndrome

Affiliations
  • 1Department of Internal Medicine, Inha University Medical College, Inchon, Korea.

Abstract

A 44 years old woman was admitted to Inha University hospital in semicomatose state. An electrocardiogram (ECG), taken in the emergency room, showed ST segment elevation in the precordial leads. She underwent a urgent echocardiography. It showed that there was akinesia of anteroseptal segment from the mid left ventricle to the apex and inferior segment from the mid left ventrile to the lower mid left ventricle. With the impression of acute myocardial infarction (AMI), she underwent a urgent coronary angiography. There was no significant luminal narrowing of the right or the left coronary arteries but the left ventriculography revealed akinesia of anterolateral and diaphragmatic segments of the left ventricle. Computerized tomography (CT) of the brain, taken shortly after coronary angiography, showed subarachnoid hemorrhage. The abnormal ECG and echocardiography findings, simulating acute myocardial infarction, were assumed to be caused by coronary vasospasm derived from subarachnoid hemorrhage accompanied by massive adrenergic discharge.

Keyword

Acute myocardiac infarction; intracranial hemorrhage

MeSH Terms

Adult
Brain
Coronary Angiography
Coronary Vasospasm
Coronary Vessels
Echocardiography
Electrocardiography
Emergency Service, Hospital
Female
Heart Ventricles
Humans
Intracranial Hemorrhages*
Myocardial Infarction
Phenobarbital
Subarachnoid Hemorrhage
Phenobarbital
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