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A Case of Subarachnoid Hemorrhage with Persistent Shock and Transient ST Elevation Simulating Acute Myocardial Infarction

蜘蛛膜下腔出血合併持續休克和暫時性ST段上升而擬似急性心肌梗塞之病例報告

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摘要


在神經血管疾病中發現的心電圖變化並非少見。蜘蛛膜下腔出血的病人,其心電圖變化可能類似心肌缺氧和急性心肌梗塞的表現。在蜘蛛膜下腔出血的早期,兒茶胺酚的釋放使大多數病人的血壓上升,相反地,低血壓則是少見的表現。我們提出一位蜘蛛膜下腔出血的患者合併有心電圖中ST段的暫時性上升與持續的休克擬似急性心肌梗塞表現,並針對蜘蛛膜下腔出血之心電圖變化的機轉提出討論。

並列摘要


Electrocardiographic changes in neurovascular disease are not rare. Patients with subarachnoid hemorrhage have electrocardiographic (ECG) abnormalities that may mimic ischemic heart disease and acute myocardial infarction. Outflow of catecholamines in the early stage of subarachnoid hemorrhage contributes to elevated blood pressure in most patients. Hypotension is a rare presentation in subarachnoid hemorrhage. We report a case of subarachnoid hemorrhage with transient ST elevation and intractable shock simulating acute myocardial infarction, and review the mechanism of ECG changes in subarachnoid hemorrhage.

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