oa Southern African Journal of Anaesthesia and Analgesia - Acute subarachnoid haemorrhage and the mysterious electrocardiogram : case studies
Subarachnoid haemorrhage (SAH) is a devastating neurological insult, and is increasingly understood as a multi-system condition initiated in the central nervous system. Perioperative investigation of patients presenting for aneurysm surgery often includes a routine electrocardiogram (ECG) which frequently reveals an abnormality. We describe a patient who presented with SAH and who was found to have significant Q waves on the ECG suggestive of a trans-mural myocardial infarction, despite a negative medical history for such an event. We briefly highlight the issues faced by the anaesthesiologist when dealing with the patient with SAH and ECG abnormality, and the implications for cardiovascular dysfunction.
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