DSAE STEMI Review, Mod 2: Subarachnoid Hemorrhage (SAH)

ECG Changes Associated with the Subarachnoid Hemorrhage (SAH)

The patient with SAH will sometimes present with ST-T changes of the cardiogram that are consistent with myocardial ischemia or infarction.  This would generally be excluded as cardiac in origin by clinical presentation, most commonly acute headache. However this could be problematic if the patient were post cardiac arrest and was unable to give the history.

Please see the tracing below from a 20 year old female with SAH

Please note the following changes visible in this tracing above:

  1.  ST elevation Concave down: V2, V3
  2. ST plateauing in V4 – V6
  3. Slight ST elevation in Leads I and II
  4. T-wave inversion Leads V1, V2 into V3