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ST elevation--an indication of reversible neurogenic myocardial dysfunction in patients with head injury

Hemant Bhagat1, Rajiv Narang, Deepak Sharma

  • 1Department of Neuroanesthesiology, All India Institute of Medical Sciences, New Delhi, India.

Annals of Cardiac Anaesthesia
|July 16, 2009
PubMed

Insights

A head injury led to meningitis symptoms and electrocardiogram changes mimicking a heart attack. Intensive care resolved these ST changes, and further tests ruled out myocardial infarction.

Area of Science:

  • Neurology
  • Cardiology
  • Critical Care Medicine

Background:

  • Head injury can precipitate various neurological complications.
  • Electrocardiogram (ECG) abnormalities can arise from non-cardiac causes.
  • Distinguishing cardiac from non-cardiac ST elevation is crucial in critical care.

Observation:

  • A patient presented with meningitis signs 4 days post-head trauma.
  • The patient exhibited ST elevation, hypotension, and elevated troponin T, suggesting myocardial infarction.
  • These cardiac-like symptoms resolved within 48 hours of intensive care.

Findings:

  • The observed ST elevation and positive troponin T were transient.
  • Investigations confirmed no evidence of actual myocardial infarction.
  • Meningitis following head injury was the primary diagnosis.

Implications:

  • This case highlights the importance of considering non-coronary causes for ST elevation in trauma patients.
  • Early recognition and management of neurological conditions can prevent misdiagnosis of cardiac events.
  • Critical care monitoring is essential for managing complex presentations after head injury.

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