伟大的模仿者：模拟急性心肌梗死的弥漫性蛛网膜下腔出血的独特病例

Q3 Medicine European journal of case reports in internal medicine Pub Date : 2024-07-04 DOI:10.12890/2024_004713

Mina Gerges, Lefika Bathobakae, Anas Mahmoud, Remon Saad, S. Elkattawy, Fayez E. Shamoon, Mourad Ismail

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引用次数: 0

摘要

蛛网膜下腔出血（SAH）是一种罕见但后果严重的急症，可能会模仿急性心肌梗死（MI）。蛛网膜下腔出血会导致交感神经活动增强，最终形成神经源性心肌骤停（NSM），表现为 ST 段偏离、QT 间期延长、T 波倒置或 Q 波。由于出血和死亡风险增加，再灌注治疗是 SAH 的禁忌症。因此，及时诊断至关重要。在此，我们报告了一例独特的大面积 SAH 病例，其表现为弥漫性 ST 段偏离，类似于急性心肌梗死。患者因心脏骤停被送到急诊科，入院第 2 天死亡。

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The great mimicker: a unique case of diffuse subarachnoid haemorrhage simulating acute myocardial infarction

Subarachnoid haemorrhage (SAH) is a rare yet consequential medical emergency that may mimic an acute myocardial infarction (MI). SAH causes enhanced sympathetic activity, culminating in the development of neurogenic stunned myocardium (NSM), which presents as ST-segment deviations, prolonged QT intervals, T-wave inversions or Q-waves. Reperfusion therapy is contraindicated for SAH because of an increased risk of bleeding and death. Therefore, a prompt diagnosis is crucial. Here, we report a unique case of massive SAH presenting as diffuse ST-segment deviation simulating an acute MI. Our patient was brought to the emergency department after a cardiac arrest and died on day 2 of admission.

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来源期刊

European journal of case reports in internal medicine

CiteScore

2.10

自引率

0.00%

发文量

166

审稿时长

8 weeks

期刊介绍： The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.