Primary intracranial hemorrhage presenting as acute myocardial ischemic syndrome.

Inha University Medical College, Inchon, Korea A 44 years old woman was admitted to Inha University hospital in semicomatose state. An electrocardiogram (ECG), taken in the emergency room, showed ST segment elevation in the precordial leads. She underwent a urgent echocardiography. It showed that there was akinesia of anteroseptal segment from the mid left ventricle to the apex and inferior segment from the mid left ventrile to the lower mid left ventricle. With the impression of acute myocardial infarction (AMI), she underwent a urgent coronary angiography. There was no significant luminal narrowing of the right or the left coronary arteries but the left ventriculography revealed akinesia of an ata4 and diaphramatic segments of the left ventricle. Computerized tomography(CT) of the brain, taken shortly after coronary angiography, showed subarachnoid hemorrhage. The abnormal ECG and echocardiography findings, simulating acute myocardial infarction, were assumed to be caused by coronary vasospasm derived from subarachnoid hemorrhage accompanied by massive adrenergic discharge.