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Background <p>Out-of-hospital cardiac arrest (OHCA) is most often due to acute coronary syndrome (ACS), but less frequent causes like subarachnoid hemorrhage (SAH) may mimic cardiac disease through ECG changes and biomarker elevation, risking misdiagnosis and inappropriate interventions. The aim of this case was to present a case of a patient who experienced OHCA due to subarachnoid hemorrhage mimicking ACS leading to catastrophic results.</p> Case presentation <p>A 42-year-old woman with no cardiovascular risk factors suffered sudden cardiac arrest during exercise. Initial ECG and troponin levels suggested SCA, but coronary angiography was normal. Subsequent head CT revealed a massive subarachnoid hemorrhage. Despite supportive care, the patient died on day 5 from cerebral edema.</p> Conclusion <p>SAH can cause cardiac arrest with ECG changes mimicking ACS, highlighting the importance of cranial CT in comatose post–cardiac arrest patients.</p>

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When subarachnoid hemorrhage mimics acute coronary syndrome in out-of-hospital cardiac arrest: a diagnostic challenge

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月26日

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  • Youssef Lahmouz,
  • Jaouad Nguadi,
  • Hanae EL Ghiati,
  • Jihane Fagouri,
  • Meryem Bennani,
  • Abdelilah Ben EL Makki,
  • Jamal Kheyi,
  • Hicham Bouzelmat,
  • Zouhair Lakhal,
  • Aatif Benyass,
  • Ali Chaib

摘要

Background

Out-of-hospital cardiac arrest (OHCA) is most often due to acute coronary syndrome (ACS), but less frequent causes like subarachnoid hemorrhage (SAH) may mimic cardiac disease through ECG changes and biomarker elevation, risking misdiagnosis and inappropriate interventions. The aim of this case was to present a case of a patient who experienced OHCA due to subarachnoid hemorrhage mimicking ACS leading to catastrophic results.

Case presentation

A 42-year-old woman with no cardiovascular risk factors suffered sudden cardiac arrest during exercise. Initial ECG and troponin levels suggested SCA, but coronary angiography was normal. Subsequent head CT revealed a massive subarachnoid hemorrhage. Despite supportive care, the patient died on day 5 from cerebral edema.

Conclusion

SAH can cause cardiac arrest with ECG changes mimicking ACS, highlighting the importance of cranial CT in comatose post–cardiac arrest patients.