American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
Open Access
Journal Browser
Go
American Journal of Medical Case Reports. 2014, 2(1), 10-11
DOI: 10.12691/ajmcr-2-1-3
Open AccessCase Report

A Rare Presentation of Acute Coronary Syndrome with Posterior Fossa Intracranial Bleed

Shazia Yasir1,

1ER Physician (PG), Ziauddin University Hospital

Pub. Date: January 16, 2014

Cite this paper:
Shazia Yasir. A Rare Presentation of Acute Coronary Syndrome with Posterior Fossa Intracranial Bleed. American Journal of Medical Case Reports. 2014; 2(1):10-11. doi: 10.12691/ajmcr-2-1-3

Abstract

Without significant coronary artery stenosis, ischemic ECG changes including ST segment elevation, segmental wall abnormality & elevated serum cardiac specific markers may develop after central nervous system injuries. Misdiagnosing these patients as acute MI may result in catastrophic outcomes. By reporting case of 56 year old male with posterior cranial fossa haemorrhage mimicking ST segment elevation MI, we hope to underline that careful attention to neurological abnormalities is critical in making correct diagnosis.

Keywords:
myocardial infarction posterior cranial fossa haemorrhage

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Cardiac manifestations of acute neurological lesions. (Oppenheimer S, Norris JW.) In: Aminoff MJ, editor. Neurology and General Medicine: the Neurological Aspects of Medical Disorder. 2nd ed. New York, NY: Churchill-Livingstone; 1995. pp. 183-200.
 
[2]  Van der Bilt IAC, Visser FC. Neurogenic induced myocardial dysfunction. Heart Metab. 2004; 24:27-30.
 
[3]  Zaroff JG, Rordorf GA, Newell JB, Ogilvy CS, Levinson JR. Cardiac outcome in patients with subarachnoid hemorrhage and electrocardiographic abnormalities. Neurosurgery. 1999; 44: 34-39. discussion 39-40.
 
[4]  The annual incidence of non traumatic intracranial haemorrhage varies from 2-22/100,000. (Ingalls T, Asplundh K, Mahoney M, Bonita R. A multinational comparison of subarachnoid haemorrhage epidemiology in the WHO MONICA stroke study. Stroke 2000: 31: 105).
 
[5]  Elrifai AM, Bailes JE, Shih SR, Dianzumba S, Brillman J. Characterization of the cardiac effects of acute subarachnoid hemorrhage in dogs. Stroke. 1996; 27: 737-741. discussion 741-2.
 
[6]  Yuki K, Ko ama Y, Onda J, Emoto K, Morimoto T, Uozumi T. Coronary vasospasm following subarachnoid hemorrhage as a cause of stunned myocardium: case report. J Neurosurg. 1991; 75: 308-311.
 
[7]  Zaroff JG, Rordorf GA, Newell JB, Ogilvy CS, Levinson JR. Cardiac outcome in patients with subarachnoid hemorrhage and electrocardiographic abnormalities. Neurosurgery. 1999; 44: 34-39. discussion 39-40.
 
[8]  Chen YL, Yu TH, Fu M. Takotsubo cardiomyopathy: transient left ventricular apical ballooning mimicking acute myocardial infarction. J Formos Med Assoc. 2006; 105: 839-843.
 
[9]  Tsuchihashi K, Ueshima K, Uchida T, et al. Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction. Angina Pectoris-Myocardial Infarction Investigations in Japan. J Am Coll Cardiol. 2001; 38: 11-18.
 
[10]  A study of primary cerebellar & pontine hemorrhage with observation on their pathogen by Henry B. D INSDALE. MD in JAMA Neurology Journal.
 
[11]  Brouwers PJ, Wijdicks EF, Hasan D, et al. Serial electrocardiographic recording in aneurysmal subarachnoid hemorrhage. Stroke. 1989; 20: 1162-1167.
 
[12]  Doshi R, Neil-Dwyer G. Hypothalamic and myocardial lesions after subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry. 1977; 40: 821-826.
 
[13]  Greenhoot JH, Reichenbach DD. Cardiac injury and subarachnoid hemorrhage: a clinical, pathological and physiological correlation. J Neurosurg. 1969; 30: 521-531.
 
[14]  Blood pressure levels in acute myocardial infarction. http://www.ncbi.nlm.nih.gov/pubmed/696568.