Acute ST-Segment Elevation: Don't Rush me to the Catheter Laboratory- Please Wait
Bassim Albizreh1, Mohammad Alibrahim1, Tahir Hamid1
1Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Heart Views : the Official Journal of the Gulf Heart Association
|February 22, 2020
Summary
ST-segment elevation mimicking heart attack can be caused by brain bleeds. This case highlights the importance of considering neurological causes in cardiac arrest patients with specific ECG findings.
Area of Science:
- Neurology
- Cardiology
Background:
- ST-segment elevation on electrocardiogram (ECG) typically suggests acute myocardial infarction.
- Out-of-hospital cardiac arrest (OHCA) requires rapid diagnosis and intervention.
Observation:
- A young woman with no prior cardiac history presented with OHCA and ST-segment elevation.
- Severe headache preceded the cardiac arrest.
- Computed tomography (CT) of the head revealed infratentorial subarachnoid hemorrhage and diffuse brain edema.
Findings:
- The patient's presentation mimicked acute coronary syndrome.
- Subarachnoid hemorrhage was identified as the underlying cause of cardiac arrest and ECG changes.
- Initial management strategies for coronary artery disease were inappropriate.
Implications:
- ST-segment elevation is not pathognomonic for coronary artery occlusion.
- Neurological emergencies, particularly subarachnoid hemorrhage, should be considered in the differential diagnosis of cardiac arrest with ST-segment elevation.
- This case underscores the need for a comprehensive diagnostic approach in critical care settings.
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