Persistent convex ST‐segment elevation in a patient with a history of prior intracerebral haemorrhage

Abstract

Management of patients with acute chest pain poses a significant challenge in identifying those requiring urgent coronary reperfusion. Electrocardiogram (ECG) constitutes the cornerstone in making prompt clinical decisions by identifying ST‐segment elevation, commonly associated with ST‐segment elevation myocardial infarction. It is important to note that ST‐segment elevation can also be a manifestation of various cardiac and non‐cardiac conditions, from acute myocarditis, early repolarization syndrome, acute pericarditis, and left bundle branch block to unknown origins. The similarity of ECG changes among these conditions complicates clinical differential diagnosis, necessitating a detailed medical history and thorough examinations. Here, we presented a case of a 52‐year‐old female with chest pain and unidentified convex ST‐segment elevation. Considering the negative emergent coronary angiography results, normal echocardiography, and long‐lasting ST‐segment elevation for the following 1 year, the final diagnosis was non‐myocardial infarction, probably related to a prior cerebral haemorrhage.