Introduction
The electrocardiogram (ECG) is a primary tool in the diagnosis of acute myocardial infarction. Other cardiac clinical conditions, such as acute pericarditis, and non-cardiac conditions, such as spontaneous subarachnoid hemorrhage, may be accompanied by arrhythmias and repolarization abnormalities .
Purpose
To increase the awareness of non-cardiac syndrome , followed by ECG abnormalities, mimicking acute myocardial infraction, and thus avoid unjustified intervention procedures, or therapy.
Materials and Patients
Case 1: A 62-year-old woman was admitted to the cardiac care unit after an epileptic seizure, syncope; a normal brain CT scan, and a pathological electroencephalogram (EEG) pattern were recorded.
The ECG showed repolarization abnormalities, suggestive of evolving an acute myocardial infarction. Cardiac serum markers and coronary angiography were normal.
Case 2: A 58-year-old woman was transferred to the emergency room due to chest discomfort, nausea, left arm pain, and numbness around her mouth. Her past medical history included diabetes mellitus, hypertension and dyslipidemia.
The ECG revealed ST elevation in the inferior leads. A chest CT angiogram was negative for aortic dissection, and demonstrated patent coronary arteries. A brain CT demonstrated an area of parenchymal bleeding in the right Thalamus.
Summary and Conclusions
We presented two patients with ECG abnormalities following cerebral events, suggestive of an acute myocardial infarction (AMI).
Awareness to non- cardiac originated ECG abnormalities , may result in correct diagnosis, and avoidance of unwarranted procedures, or therapy.
