Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report

Adeba Mohammad; Dennis Grewal; Islam Abudayyeh; Mamas A Mamas; Pooja Swamy; Purvi Parwani

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Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report

Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report

作者：

Adeba Mohammad Dennis Grewal Islam Abudayyeh Mamas A Mamas Pooja Swamy Purvi Parwani

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ST-elevation

myocardial

infarction

Acute

coronary

syndrome

Stress

induced

cardiomyopathy

Coronary

artery

vasospasm

Cerebral

vasospasm

Subarachnoid

hemorrhage

Case

report

摘要：

BACKGROUND Coronary artery vasospasm(CAV)is a reversible,transient form of vasoconstriction with clinical manifestations ranging from stable angina to acute coronary syndromes(ACS).Vasospasm of epicardial coronary arteries or associated micro-vasculature can lead to total or subtotal occlusion and has been demonstrated in nearly 50%of patients undergoing angiography for suspected ACS.The mechanism for CAV has been described in literature,but in a subgroup of patients presenting with intracranial hemorrhage,it appears to be multifactorial.These patients tend to have electrocardiographic changes,elevation of cardiac biomarkers of injury and neurogenic stress cardiomyopathy.CASE SUMMARY A 44-year-old woman presented with severe headaches and tonic-clonic seizures.She was found to have diffuse subarachnoid hemorrhage(SAH)requiring ventricular drain placement,coil embolization and induced hypertension.She subsequently developed chest pain with ST elevations in anterior precordial leads,elevated cardiac enzymes and apical ballooning with left ventricular ejection fraction of 35%on transthoracic echocardiogram.Coronary angiogram revealed severe diffuse triple vessel stenoses secondary to CAV seen distally.Subsequent cardiac MRI notable for apical non-viability and scar formation.CONCLUSION This case highlights a unique etiology of acute myocardial infarction in a patient with SAH leading to ST elevations,diffuse triple vessel CAV and apical scar.

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世界心脏病学杂志：英文版（电子版）2021 世界心脏病学杂志：英文版（电子版）2020 世界心脏病学杂志：英文版（电子版）2019

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篇名	Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report
来源期刊	世界心脏病学杂志:英文版(电子版)	学科	医学
关键词	ST-elevation myocardial infarction Acute coronary syndrome Stress induced cardiomyopathy Coronary artery vasospasm Cerebral vasospasm Subarachnoid hemorrhage Case report
年，卷（期）	2020,（9）	所属期刊栏目
研究方向		页码范围	468-474
页数	7页	分类号	R54
字数		语种
DOI