A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?

Abstract

Introduction: Twenty percent of all strokes are hemorrhagic and 50% of hemorrhagic strokes are because of subarachnoid hemorrhage (SAH). Cardiac abnormalities and electrocardiographic (ECG) changes are commonly seen after SAH. Here, we present a patient with a sudden loss of consciousness, respiratory arrest, and diffuse ST segment changes in ECG. Case Report: A 52-year-old wife, who had only hypertension in her medical history, learnt that her husband had a blunt trauma to the head and a decompressive craniectomy was performed. While he was sent to an intensive care unit, his wife collapsed just outside the emergency department (ED). The female patient had a respiratory arrest and then entered ventricular fibrillation. After Cardiopulmonary resuscitation (CPR) and 200 J defibrillation, the monitor showed an atrial fibrillation rhythm and the pulse returned. The ECG showed elevations in ST segments and a percutaneous coronary intervention was planned. Meanwhile, emergency physicians suspected an intracranial pathology and a computed tomography (CT) scan revealed a diffuse SAH. Conclusion: The clinical findings and the patient history are very important to avoid malpractice. If the physicians do not give sufficient attention to these areas, the patients can easily be mistreated.