Subarachnoid haemorrhage and the electrocardiogram - a review

Electrocardiographic abnormalities occur in approximately 50% of patients with subarachnoid haemorrhage. The changes can resemble those of myocardial damage, although in most cases post-mortem studies show no macroscopic evidence of injury. Failure to appreciate this can lead to misdiagnosis of organic cardiac disease, cause delay in surgical treatment or even lead to inappropriate therapy. This review deals with the changes that may occur in the electrocardiogram, discusses the explanations put forward, and examines how this may influence future trends in management.