CEREBROGENIC ECG-CHANGES AFTER SUBARACHNO ID HEMORRHAGE SECONDARY TO A CAROTID ANEURYSM - DIFFERENTIATION TO ACUTE MYOCARDIAL-INFARCTION

ECG-changes simulating acute posterior myocardial infarction were obse rved in a 62-year-old woman 16 days after acute subarachnoid hemorrhag e. An acute myocardial ischemia was excluded by enzyme laboratory test s and by coronary angiography. The transient ECG-changes can be explai ned by short-term spasms of small distal arterioles in the heart, whic h were affected by a derangement of autonomic function, The present ca se demonstrates ECG-changes in a patient with subarachnoid hemorrhage very late after the acute event. Therefore, patients with intracranial hemorrhage should have a prolonged electrocardiographical aftercare. ECG-changes in patients with subarachnoid hemorrhage were discussed as a specific parameter describing the degree of intracranial damage and as a predictive value for a poor outcome. Because of ventricular arrh ythmias and the occurrence of sudden cardiac death in patients with su barachnoid hemorrhage critical care monitoring should be performed aft er detection of new ECG-changes.