Krwawienie podpajęczynówkowe imitujące ostry zespół wieńcowy jako przyczyna pozaszpitalnego zatrzymania krążenia

Abstract

Należy cytować anglojęzyczną wersję artykułu z: Lewandowski P: Subarachnoid haemorrhage imitating acute coronary syndrome as a cause of out-of-hospital cardiac arrest -case report. Anaesthesiol Intensive Ther 2014; 46: 289-292 Case report: A 47-year-old man presented with a history of out-of-hospital cardiac arrest due to asystole. He had a medical history of hypertension, smoking, and a diffuse, severe headache for one week. The ECG showed atrial fibrillation, 0,2 mV ST-segment elevation in leads aVR and V1-V3 and 0.2 mV ST-segment depression in leads I, II, aVL and V4-V6. Echocardiography revealed left ventricular function impairment (ejection fraction < 20%). The CK-MB activity was 98 U L -1 and the troponin I concentration was 0.59 µg L -1 . ACS was suspected. Coronarography did not reveal any changes in the coronary arteries. An urgent CT of the head was arranged and showed an extensive SAH.Conclusions: It appears that an urgent CT of the head is the most effective method for the early identification of SAH-induced OHCA, especially in patients with prodromal headache, no history of the symptoms of ACS and CA due to asystole/pulseless electrical activity (PEA). Out-of-hospital cardiac arrest (OHCA) predominantly develops due to acute coronary syndrome (ACS). Extra-cardiac causes, e.g., subarachnoid haemorrhage (SAH), are less common. The purpose of the present case report was to describe a patient with OHCA due to subarachnoid haemorrhage imitating acute coronary syndrome.

Post-Coital Sudden Cardiac Arrest Due to Non- Traumatic Subarachnoid Hemorrhage—A Case Report

“…20 In patients with post-arrest SAH, however, ST segment elevations can be seen on ECG despite finding normal coronary vessels on angiography, suggesting that emergent PCI in these patients may be futile. 1,2 According to a study, evaluating patients with STEMI presentation on ECG being referred for primary PCI, there was a 2.3% incidence of non-acute coronary syndrome (ACS) cases. 21 Thus it is imperative to retain a broad differential and high clinical suspicion of non-ACS conditions to avoid anchoring bias.…”

Post-coital sudden cardiac arrest due to non-traumatic subarachnoid hemorrhage - a case report

“…While the majority of SCA are caused by underlying cardiac disease and arrhythmias, other etiologies include: electrolyte disturbances, drug intoxication, autonomic nervous system dysfunction, and acute intracranial events. 2 …”