ST‑segment elevation associated with intraparenchymal hemorrhage: A case report
Manuel Alejandro Giraldo-Delgado1, Mateo Zuluaga-Gómez2,3, Daniel González-Arroyave2
1Emergency Medicine Department, Faculty of Medicine, University CES, 050012 Medellín, Colombia.
Insights
Electrocardiogram (ECG) changes can mimic heart attacks but may indicate intraparenchymal hemorrhage (IPH). Prompt brain computed tomography is crucial for diagnosing intracranial hemorrhage presenting with ST-segment elevation.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Electrocardiogram (ECG) changes in patients with intraparenchymal hemorrhage (IPH) are not well-documented.
- No prior case reports exist detailing ECG findings associated with IPH.
- ST-segment elevation on ECG typically suggests acute myocardial infarction.
Abstract:
The electrocardiogram (ECG) changes in patients with intraparenchymal hemorrhage (IPH) have remained largely elusive and no case reports are currently available in the scientific literature. The medical management of a patient with ST-segment elevation associated with IPH was described in the present study. The case report describes a 78-year-old male patient who presented with ST-segment elevation in V1, V2, V3 and V4 on ECG. Initially, the case was managed therapeutically as an acute myocardial infarction. Later, the patient was transferred to a higher-level hospital, where a new ECG confirmed ST-segment elevation. Simple skull tomography was also performed, which revealed a spontaneous right basal ganglion in the context of an acute cerebrovascular accident of hypertensive origin. A transthoracic ECG was ordered, which revealed an ejection fraction of 65% with type I diastolic dysfunction due to relaxation disorders and without any signs of ischemia, intracavitary masses or thrombi. In addition to the presence of nonspecific ECG findings, clinicians should consider immediate brain computed tomography to confirm intracranial hemorrhage.
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