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BMJ Case Reports 2012; doi:10.1136/bcr.11.2011.5134
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Subarachnoid haemorrhage mimicking acute myocardial infarction

  1. Sylvestre Maréchaux1
  1. 1Cardiology Department, GHICL/CH St Philibert/Faculté libre de médecine de Lille, Lomme, France
  2. 2Neurology Department, GHICL/CH St Philibert/Faculté libre de médecine de Lille, Lomme, France
  3. 3Cardiology Department, Institut Cardiovasculaire Paris Sud/Hopital privé Jacques Cartier, Massy, France
  4. 4Radiology Department, GHICL/CH St Philibert/Faculté libre de médecine de Lille, Lomme, France
  1. Correspondence to Dr Sylvestre Maréchaux, sylvestre.marechaux{at}yahoo.fr

Description

A 54-year-old obese woman with a history of hypertension dialed ambulance service for headache and vomiting. EKG found diffuse ST segment elevation (figure 1A). Prehospital management consisted of intravenous aspirin, oral antiplatelet therapy (prasugrel) and subcutaneous low-molecular-weight heparin. She was transferred in our intensive care unit. Echocardiography showed impaired left ventricular ejection fraction (30%) with apical dysfunction but preserved basal function (figure 1B–D). Coronary angiography showed normal epicardial coronary arteries (figure 1E,F …

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