Hypertensive intracerebral hemorrhage simulating acute myocardial infarction

✍ Scribed by Sadasiva Rao Katta; William A Berk

• Publisher: Elsevier Science
• Year: 1992
• Tongue: English
• Weight: 817 KB
• Volume: 21
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(05)82944-0

✦ Synopsis

The decision to administer thrombolytic therapy for acute myocardial infarction depends on clinical presentation and characteristic ECG findings of acute injury. Inappropriate initiation of thrombolysis may occur when other clinical entities mimic myocardial infarction both clinically and electrocardiographically. We present the case of a 49-year-old woman who presented with cardiovascular collapse and ECG findings strongly suggestive of myocardial infarction. Computed brain tomography eventually revealed right temporal lobe hemorrhage, the apparent cause of the observed ECG abnormalities. ST-segment elevation resolved rapidly, and serial creatine phosphokinase isoenzyme determinations were negative. Because closed-chest cardiac massage had been performed, a thrombolytic agent was not administered. Our experience emphasizes the importance of considering ECG findings in light of clinical presentation and of taking care to consider conditions other than myocardial infarction that may cause ST-segment elevation.