A Case of Subarachnoid Hemorrhage with Acute Myocardial Infarction: A Therapeutic Challenge Overcome with a Multidisciplinary Approach

Case RepoRtanticoagulants, antiplatelets, or delay in cardiological as well as neurosurgical intervention.Moreover, the use of a drug-coated balloon (DCB) to keep a balance between minimum risk of intracranial bleeding and prevention of stent thrombosis/stenosis was also a unique approach for this patient with high bleeding risk (HBR).We present a case of SAH complicated by AMI where timely and judicious neurosurgical and cardiological intervention has IntroductIonAcute myocardial infarction (AMI) is a rare but life-threatening association with subarachnoid hemorrhage (SAH). 1 Acute coronary syndrome (ACS), which is a potentially reversible medical emergency, can lead to cardiac arrest if not intervened in a timely manner.ACS can result from cardiac ischemia leading to myocardial injury or necrosis.Various neurological disorders can mimic the electrocardiogram (ECG) changes observed in ACS.These conditions include SAH, intracranial hemorrhage (ICH), subdural hematoma, brain tumors, brain abscesses, tuberculoma, and meningitis.However, these observations are not very common in clinical practice and the literature. 2 Intracranial hemorrhage (trauma-induced or spontaneous) can elicit sympathetic stimulation, leading to cardiac repolarization and thus inducing ST changes on ECG.Raised intracranial tension and activation of the sympathetic nervous system can stimulate catecholamine release, influencing cardiac dynamics.3 However, differentiating primary cardiac pathology from neurologically (SAH) induced ECG alterations involves intricate assessment of clinical symptoms, serial troponin level tracing, and imaging studies to accurately diagnose the underlying cause of abnormal ST segment changes, which is crucial for appropriate clinical management.This was an extremely rare and crucial clinical scenario of diagnostic dilemma, as misdiagnosis can lead to delayed use of 1,