Cerebrogenic Sudden Cardiac Death

Case Report

Austin J Clin Cardiolog. 2016; 3(2): 1052.

Cerebrogenic Sudden Cardiac Death

Ali Raza Ghani*, Saddaf Mirrani, Hafeez Virk, Khawar Maqsood and Ghazi Mirrani

Thomas Jefferson University Hospital, USA

*Corresponding author: Ali Raza Ghani, Thomas Jefferson University Hospital, Philadelphia, USA

Received: August 10, 2016; Accepted: November 04, 2016; Published: November 08, 2016


An ST segment elevation is a life threatening condition requiring immediate intervention in many cases. The presentation can be very misleading, specially the presence of neurological symptoms warrants to an alternate diagnosis. We are presenting an interesting case with ST elevation on EKG, in a patient with acute insular infarction.


Various EKG patterns have been well documented with cerebral infarction and particularly insular infarct has been associated with ST elevation on the EKG. The Mechanism of this finding is not clearly understood but insular infarct seems to activate sympathetic - adrenal system because of decreased inhibitory insular activity.

Case Report

A 43-year-old female with endometrial cancer admitted for hysterectomy had a syncopal episode on the second postoperative day with a small amount of vaginal bleeding. Patient was hypotensive, diaphoretic and delirious. She was noticed to have dense left hemi paresis. Her ECG (Figure 1) showed ST elevation in leads I, a VL and ST depression in lead II, III, a VF and V3-V6. The obvious diagnosis was acute inferior ST elevation myocardial infarction but patient also developed dense left hemi paresis and was very confused. Her CT scan of brain revealed acute right middle cerebral artery stroke. Pt was not a t-PA candidate due to risk of hemorrhagic conversion of infarct. Patient had Pulseless Electrical Activity (PEA) cardiac arrest in radiology department and she re-gained her pulse and blood pressure after 2 cycles and was taken to catheterization lab. Her coronary angiogram did not show any obstructive disease. She again had PEA arrest in catheterization lab and died despite resuscitative measures. Autopsy showed patent foramen ovale raising concern for paradoxical embolism.

Citation: Ghani AR, Mirrani S, Virk H, Maqsood K and Mirrani G. Cerebrogenic Sudden Cardiac Death. Austin J Clin Cardiolog. 2016; 3(2): 1052. ISSN : 2381-9111