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Cerebral arteriovenous malformation mimicking acute coronary syndrome
O Noordally1, D Mircev, M K Luabeya
1Department of Intensive Care Medicine, Clinique St. Anne St Remi-St Etienne, Site St Etienne, Brussels, Belgium.
Insights
A rare case of cerebral arteriovenous malformation caused chest pain mimicking a heart attack. Neurological evaluation revealed a left temporal and parietal arteriovenous malformation, likely causing seizures and chest pain.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Cerebral arteriovenous malformations (AVMs) are complex vascular abnormalities in the brain.
- AVMs can present with diverse neurological symptoms, including seizures and hemorrhage.
- Unexplained chest pain can sometimes be a referred symptom of neurological conditions.
Observation:
- A 34-year-old male presented with chest pain and ST elevations on electrocardiography.
- Coronary angiography revealed no coronary artery lesions, and cardiac enzymes were normal.
- Neuroimaging confirmed a large cerebral arteriovenous malformation in the left temporal and parietal lobes.
Findings:
- The patient's chest pain was ultimately attributed to a complex partial seizure, a neurological event.
- This case highlights the importance of considering non-cardiac etiologies for chest pain, especially in the presence of neurological findings.
- Cerebral AVMs can manifest with symptoms that mimic other serious medical conditions.
Implications:
- This case underscores the diagnostic challenges posed by atypical presentations of cerebral AVMs.
- It emphasizes the need for a comprehensive differential diagnosis in patients with unexplained chest pain.
- Early recognition and appropriate management of cerebral AVMs are crucial to prevent potentially devastating outcomes.
Abstract:
We report a case of cerebral arteriovenous malformation in a 34 year-old male patient presenting with chest pain. Electrocardiographic findings showed ST elevations in the precordial leads. However, a coronary angiogram showed no coronary lesions. Laboratory tests suggested that troponin and cardiac enzymes were within normal limits. Further investigation led to the diagnosis of a cerebral arterio-venous malformation occupying the left temporal and parietal lobes. The chest pain may be explained by the occurrence of a complex partial seizure.