Introduction
Subarachnoid haemorrhage (SAH) is a neurological emergency with high mortality rates.
Most common causes are rupture of aneurysm (congenital/infectious/traumatic) or rupture of arteriovenous malformation.
Cardiac abnormalities are present in more than 50% of patients with SAH.
Patients with SAH can have myocardial ischemia due to the increased level of circulating catecholamines or to autonomic stimulation from the brain.
ECG manifestation
- ST-segment elevations or depressions that can mimic acute myocardial infarction
- widespread giant T wave inversions (“cerebral T waves”)
- large U waves
- prolonged QT interval
- rhythm disturbances
ECG 1 Subarachnoid hemorrhage in a 40-year old patient
- ST elevations mimicking STEMI/pericarditis (II, III, aVF, V1-V3)
References
- Chatterjee S. ECG Changes in Subarachnoid Haemorrhage: A Synopsis. Neth Heart J. 2011;19(1):31-34. doi:10.1007/s12471-010-0049-1
- https://www.ahajournals.org/doi/pdf/10.1161/01.STR.5.3.384
- https://pmj.bmj.com/content/postgradmedj/57/667/294.full.pdf
Introduction
Subarachnoid haemorrhage (SAH) is a neurological emergency with high mortality rates.
Most common causes are rupture of aneurysm (congenital/infectious/traumatic) or rupture of arteriovenous malformation.
Cardiac abnormalities are present in more than 50% of patients with SAH.
Patients with SAH can have myocardial ischemia due to the increased level of circulating catecholamines or to autonomic stimulation from the brain.
ECG manifestation
- ST-segment elevations or depressions that can mimic acute myocardial infarction
- widespread giant T wave inversions (“cerebral T waves”)
- large U waves
- prolonged QT interval
- rhythm disturbances
ECG 1 Subarachnoid hemorrhage in a 40-year old patient
- ST elevations mimicking STEMI/pericarditis (II, III, aVF, V1-V3)
References
- Chatterjee S. ECG Changes in Subarachnoid Haemorrhage: A Synopsis. Neth Heart J. 2011;19(1):31-34. doi:10.1007/s12471-010-0049-1
- https://www.ahajournals.org/doi/pdf/10.1161/01.STR.5.3.384
- https://pmj.bmj.com/content/postgradmedj/57/667/294.full.pdf
