Korean J Anesthesiol.  1999 May;36(5):901-905. 10.4097/kjae.1999.36.5.901.

Anesthetic Management of Cerebral Subarachnoid Hemorrhage with Intraoperative Electrocardiographic Change Simulating Acute Myocardial Infarction: A case report

• Shin IW
• Shn JT
• Hwang KI
• Yang WC
• Lee HK
• Chung YK

• KMID: 2240084
• DOI: http://doi.org/10.4097/kjae.1999.36.5.901

Abstract

It is now well established that acute subarachnoid hemorrhage secondary to rupture of a cerebral aneurysm can precipitate life-threatening cardiac arrhythmia. We experienced a 60 year old patient with a subarachnoid hemorrhage (neurologic grade III) due to rupture of anterior communicating artery aneurysm who presented with such intraoperative electrocardiographic changes as ST segment elevation and T wave inversion which are hallmark of acute myocardial infarction. The operation was uneventfully ended. On the postoperative laboratory examination about suspected acute myocardial infarction, the patient was found to have normal triple enzyme study and echocardiographic finding. The electrocardiogram three days after subarachnoid hemorrhage due to cerebral aneurysm returned to normal sinus rhythm. This case suggests that this patient's electrocardiographic change simulating acute myocardial infarction is transient change due to subarachnoid hemorrhage.

Keyword

Brain, cerebral aneurysm; Complications, cardiovascular, myocardial infarction

MeSH Terms

Arrhythmias, Cardiac
Echocardiography
Electrocardiography*
Humans
Intracranial Aneurysm
Middle Aged
Myocardial Infarction*
Rupture
Subarachnoid Hemorrhage*