Related Experiment Video
Updated: Jun 23, 2026
09:14
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
When ST Elevation Is Not STEMI: Autonomic-Mediated Repolarization Abnormalities After Subarachnoid Hemorrhage.
Anand Shah1, Robin H White2, Ziad Faramand1,3
1Department of Emergency Medicine, Northeast Georgia Medical Center, Gainesville, GA, USA.
The American Journal of Case Reports
|June 21, 2026
Summary
Subarachnoid hemorrhage (SAH) can cause ST-segment elevation myocardial infarction (STEMI)-like ECG changes due to autonomic dysregulation, mimicking heart attacks. Recognizing these SAH-induced changes is crucial in elderly patients to prevent misdiagnosis and guide appropriate care.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- Subarachnoid hemorrhage (SAH) is a critical neurological event, particularly dangerous in the elderly.
- Aneurysmal SAH in older adults presents atypically, often with ECG abnormalities mimicking acute coronary syndromes.
- This mimicry can delay diagnosis and increase complication rates in geriatric patients.
Purpose of the Study:
- To report a case of ST-segment elevation myocardial infarction (STEMI) mimicry caused by subarachnoid hemorrhage (SAH) in an elderly patient.
- To highlight the diagnostic challenges and pitfalls associated with SAH-induced ECG changes in the geriatric population.
- To emphasize the importance of recognizing autonomic dysregulation in SAH to avoid misdiagnosis.
Main Methods:
- Case report of a nonagenarian patient presenting with sudden headache and hypertensive crisis.
- Initial diagnostic workup included electrocardiography (ECG) and computed tomography angiography (CTA).
- Further investigations involved echocardiography and serial ECG monitoring.
Main Results:
- The patient presented with ECG findings suggestive of STEMI, but troponin levels were normal.
- CTA confirmed a ruptured anterior communicating artery aneurysm with Fisher Grade 3 SAH.
- ECG changes resolved spontaneously within 24 hours, and echocardiography showed no ischemic abnormalities.
- The patient experienced complications including bacteremia and embolic infarcts, leading to palliative care and hospice transition.
Conclusions:
- SAH can induce STEMI-like ECG changes via autonomic dysregulation, independent of coronary ischemia.
- Geriatric SAH management necessitates careful consideration of patient frailty and comorbidities.
- Early identification of SAH-related ECG abnormalities is vital for accurate diagnosis and appropriate intervention in elderly individuals.
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