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Transient J wave-like ST-segment elevation in intracerebral hemorrhage: a case report
1Department of Electrophysiology, Yijishan Hospital of Wannan Medical College, 2 Zheshan Road, Wuhu, China.
Insights
Intracerebral hemorrhage can cause transient J wave-like ST-segment elevation on electrocardiograms (ECG). Follow-up ECGs and cardiac enzyme tests help differentiate this from acute myocardial infarction, avoiding unnecessary procedures.
Area of Science:
- Cardiology
- Neurology
- Medical Diagnostics
Background:
- Cerebrovascular events, such as intracerebral hemorrhage (ICH), can manifest with electrocardiography (ECG) abnormalities and cardiac dysfunction.
- Common ECG findings include nonspecific ST-T changes, T wave abnormalities, QT interval prolongation, and ST-segment depression or elevation.
Observation:
- A case of a 58-year-old woman with right basal ganglia region cerebral hemorrhage is presented.
- Her ECG revealed transient J wave-like ST-segment elevation, accompanied by elevated cardiac biomarkers (troponin I and myocardial enzymes).
Findings:
- J wave-like ST-segment elevation on ECG is not exclusive to primary ischemic heart disease and can occur in patients with ICH.
- This ECG pattern in ICH patients may mimic acute myocardial infarction (AMI).
Implications:
- Distinguishing ICH-related J wave-like ST-segment elevation from AMI is crucial for appropriate patient management.
- Serial ECGs, myocardial enzyme analysis, and echocardiography can aid in differentiating these conditions.
- This approach may prevent unnecessary cardiac catheterization in patients with ICH presenting with these ECG changes.
Background:
Certain cerebrovascular events can induce electrocardiography (ECG) abnormalities and cardiac dysfunction. The most frequent patterns reported are nonspecific ST-T change, inverted or broad T wave, prolongation of QT interval as well as ST-segment depression or elevation. Here we present a case of intracerebral hemorrhage (ICH) with transient J wave-like ST-segment elevation accompanied by myocardial lesion.
Case Presentation:
A 58-year-old woman was admitted to our hospital and diagnosed with right basal ganglia region cerebral hemorrhage. The ECG recorded on the second hospital day showed transient J wave-like ST-segment elevation accompanied by increased myocardial troponin I and myocardial enzyme.
Conclusions:
The J wave-like ST-segment elevation may be not a specific ECG signs for primary ischemic heart diseases as it also could be found in ICH patients. We believe that the follow-up ECGs can be used in conjunction with repeated myocardial enzyme analysis and echocardiography to differentiate ICH-ralated J wave-like ST-segment elevation from acute myocardial infarction (AMI), thus avoiding unnecessary cardiac catheterization.
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