Subarachnoid hemorrhage can induce severe electrocardiographic changes mimicking acute myocardial infarction due to widespread focal myocytolysis rather than coronary ischemia.
Caution against ECG-based MI diagnosis in subarachnoid hemorrhage; case report leaves open neurogenic myocytolysis mechanisms.
A 74-year-old Japanese woman with subarachnoid hemorrhage was admitted to our hospital. During her hospitalization, serial electrocardiograms showed the combination of abnormal Q waves, ST-segment elevation, and T-wave inversion, which strongly suggested acute myocardial infarction. However, postmortem examination revealed widespread focal myocytolysis of the myocardium which was unrelated to vascular distribution.
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Sakamoto et al. (1996) studied this question.
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