QRS CHANGES, PULMONARY EDEMA, AND MYOCARDIAL NECROSIS ASSOCIATED WITH SUBARACHNOID HEMORRHAGE

A 49-year-old Caucasian female without history of cardiovascular diseases presented with a subarachnoid hemorrhage, severe hypertension, and pulmonary edema. Despite QRS changes of extensive myocardial infarction, postmortem examination revealed normal coronary arteries. Microscopic study showed extensive myocardial necrosis unrelated to vascular pattern and similar to that induced by exogenous catecholamines. The ECG changes and pulmonary edema appear to be the result of a neurohumoral myocarditis with left ventricular damage and failure. Implications for heart transplantation are cited. © 1969.