Cardiac Injury and Subarachnoid Hemorrhage: A Clinical, Pathological, and Physiological Correlation

Abstract

LECTROCARDIOGRAPHIC (ECG) abnormalities associated with central nervous system disorders are weU known, having been reported with such diverse conditions as status epilepticus, 2~ subarachnoid hemorrhage, meningitis, cerebral infarction, and intracranial mass lesions. 1,~,m7 A variety of ECG alterations have been reported, seen most consistently with subarachnoid and intracerebral hemorrhages. The most common abnormalities are depression or elevation of ST segments, prolongation of Q-T intervals, and inversion of T waves. No pathological changes in the heart were described until 1964 when Koskelo, et al., ~~ reported three cases of subarachnoid hemorrhage with ECG changes, and mentioned several small subendocardial petechial hemorrhages seen at postmortem. No other cardiac abnormalities were noted, and the pathogenesis of the electrographic abnormalities has remained unclear. We have seen a variety of structural changes in hearts of patients dying with subarachnoid hemorrhage, several of whom had abnormal ECG's, and we have produced similar changes experimentally in cats. In this communication we will present our clinical material, the experimental results, and some comments on the pathology of this heart lesion.