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IntroductionSubarachnoid Hemorrhage (SAH) resulting from the spontaneous rupture of an aneurysm is a rare and highly debilitating condition. Despite its severity, patients with aneurysmal SAH remain understudied, particularly concerning the evaluation of the incidence and consequences of subsequent acute kidney injury (AKI).
Smith comment: before reading anything else, this case screamed pulmonary embolism to me. CT chest showed left sided pulmonary embolism and a pulmonary infarct that had previously been mistaken for pneumonia. There was 100% proximal LAD occlusion with TIMI 0 flow, and cardiacarrest in the cath lab.
I suspect this is Type 2 MI due to prolonged severe hypotension from cardiacarrest. The patient's heart had significant recovery: Echo : Estimated LVEF 32%, apical wall motion abnormality with diastolic distortion (LV aneurysm), suggestive of old MI. pulmonary embolism, sepsis, etc.), myocarditis).
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