{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T02:55:20Z","timestamp":1777776920468,"version":"3.51.4"},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T00:00:00Z","timestamp":1597017600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cardiac abnormalities are frequently reported in acute subarachnoid hemorrhage (SAH) patients. However, frank ST-elevation and myocardial dysfunction mimicking acute coronary syndrome is a rare occurrence. Systemic and local catecholamine release mediate myocardial injury and may explain raised troponin levels, concordant regional wall motion abnormalities and systolic dysfunction. These findings can pose a significant problem in the acute setting where \u201ctime-is-muscle\u201d paradigm can rush clinicians towards a \u201crule-in\u201d diagnosis of acute myocardial infarction.<\/jats:p>\n                  <jats:p>We present the case of a 60-year-old male who arrived at a regional emergency department with loss of consciousness, chest pain and headache. His ECG showed ST-elevation in precordial leads with corresponding region wall motion abnormalities and dynamically elevated troponin levels which supported a diagnosis of acute myocardial infarction. Percutaneous coronary intervention was attempted but found no hemodynamically significant lesions and the patient was managed conservatively with antithrombotic treatment. Further work-up for his headache led to the diagnosis of aneurysmal SAH and subsequent endovascular coiling. The patient was discharged with a good clinical outcome. We discuss the potential catastrophic consequences of interpreting neurologic myocardial stunning as STEMI. Use of potent antithrombotic therapies, like bridging thrombolysis, in this setting can lead to dismal consequences. Clinical history should still be carefully obtained in the acute setting in this era of sensitive biomarkers.<\/jats:p>","DOI":"10.2478\/rjim-2020-0010","type":"journal-article","created":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T10:29:56Z","timestamp":1590488996000},"page":"173-177","source":"Crossref","is-referenced-by-count":3,"title":["Stress cardiomyopathy misinterpreted as ST-segment elevation myocardial infarction in a patient with aneurysmal subarachnoid hemorrhage: a case report"],"prefix":"10.2478","volume":"58","author":[{"given":"Iulian","family":"Enache","sequence":"first","affiliation":[{"name":"Department of Neurology , University Emergency Hospital Bucharest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u0103zvan Alexandru","family":"Radu","sequence":"additional","affiliation":[{"name":"Department of Neurology , University Emergency Hospital Bucharest"},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena Oana","family":"Terecoas\u0103","sequence":"additional","affiliation":[{"name":"Department of Neurology , University Emergency Hospital Bucharest"},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan","family":"Dorob\u0103\u0163","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging , University Emergency Hospital Bucharest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Tiu","sequence":"additional","affiliation":[{"name":"Department of Neurology , University Emergency Hospital Bucharest"},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2020,8,10]]},"reference":[{"key":"2026042915192764909_j_rjim-2020-0010_ref_001_w2aab3b7b8b1b6b1ab1ab1Aa","doi-asserted-by":"crossref","unstructured":"1. WARTENBERG KE, MAYER SA. Medical Complications After Subarachnoid Hemorrhage. Neurosurg Clin N Am. 2010; 21(2):325\u201338.10.1016\/j.nec.2009.10.012","DOI":"10.1016\/j.nec.2009.10.012"},{"key":"2026042915192764909_j_rjim-2020-0010_ref_002_w2aab3b7b8b1b6b1ab1ab2Aa","doi-asserted-by":"crossref","unstructured":"2. ARONOW WS. Neurogenic stress cardiomyopathy associated with subarachnoid hemorrhage. Future Cardiol. 2015; 11(1):77\u201387.10.2217\/fca.14.73","DOI":"10.2217\/fca.14.73"},{"key":"2026042915192764909_j_rjim-2020-0010_ref_003_w2aab3b7b8b1b6b1ab1ab3Aa","doi-asserted-by":"crossref","unstructured":"3. HUANG CC, HUANG CH, KUO HY, CHAN CM, CHEN JH, CHEN WL. The 12-lead electrocardiogram in patients with subarachnoid hemorrhage: Early risk prognostication. Am J Emerg Med. 2012; 30(5):732\u20136.10.1016\/j.ajem.2011.05.003","DOI":"10.1016\/j.ajem.2011.05.003"},{"key":"2026042915192764909_j_rjim-2020-0010_ref_004_w2aab3b7b8b1b6b1ab1ab4Aa","doi-asserted-by":"crossref","unstructured":"4. 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KRISHNAMOORTHY V, BURKHARD MACKENSEN G, GIBBONS EF, VAVILALA MS. Cardiac dysfunction after neurologic injury what do we know and where are we going? Chest. 2016; 149(5):1325\u201331.10.1016\/j.chest.2015.12.014","DOI":"10.1016\/j.chest.2015.12.014"},{"key":"2026042915192764909_j_rjim-2020-0010_ref_012_w2aab3b7b8b1b6b1ab1ac12Aa","doi-asserted-by":"crossref","unstructured":"12. TAMIS-HOLLAND JE, JNEID H, REYNOLDS HR, AGEWALL S, BRILAKIS ES, BROWN TM, et al. Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association. Circulation. 2019; 139(18):E891\u2013908.10.1161\/CIR.0000000000000670","DOI":"10.1161\/CIR.0000000000000670"},{"key":"2026042915192764909_j_rjim-2020-0010_ref_013_w2aab3b7b8b1b6b1ab1ac13Aa","doi-asserted-by":"crossref","unstructured":"13. KENIGSBERG BB, BARNETT CF, MAI JC, CHANG JJ. Neurogenic Stunned Myocardium in Severe Neurological Injury. 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WYBRANIEC M, MIZIA-STEC K, KRZYCH \u0141. Neurocardiogenic injury in subarachnoid hemorrhage: A wide spectrum of catecholamin-mediated brain-heart interactions. Cardiol J. 2014; 21(3):220\u20138.10.5603\/CJ.a2014.0019","DOI":"10.5603\/CJ.a2014.0019"},{"key":"2026042915192764909_j_rjim-2020-0010_ref_017_w2aab3b7b8b1b6b1ab1ac17Aa","doi-asserted-by":"crossref","unstructured":"17. MEDINA DE CHAZAL H, DEL BUONO MG, KEYSER-MARCUS L, MA L, MOELLER FG, BERROCAL D, et al. Stress Cardiomyopathy Diagnosis and Treatment: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018; 72(16):1955\u201371.10.1016\/j.jacc.2018.07.072","DOI":"10.1016\/j.jacc.2018.07.072"},{"key":"2026042915192764909_j_rjim-2020-0010_ref_018_w2aab3b7b8b1b6b1ab1ac18Aa","doi-asserted-by":"crossref","unstructured":"18. BULSARA KR, MCGIRT MJ, LIAO L, VILLAVICENCIO AT, BOREL C, ALEXANDER MJ, et al. 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