A case of subarachnoid hemorrhage associated with reversible midsystolic click sound *
We describe a 49-year-old female who presented with a reversible midsystolic click in the acute phase of subarachnoid hemorrhage. This patient was admitted because of subarachnoid hemorrhage. On admission, a midsystolic click was heard at the cardiac apex. An electrocardiogram showed ST-segment elevation in many leads suggesting transmural myocardial injury. An echocardiogram disclosed severe hypokinesis of the left ventricular wall including the papillary muscle. This improved on the seventh day of admission , and the midsystolic click disappeared simultaneously. It was, therefore , suggested that the click was due to papillary muscle dysfunction, and that a reversible midsystolic click might be heard not only in ischemic heart disease, but also in left ventricular asynergy due to subarachnoid hemorrhage. (Accepted on March 25, 1998) Kawasaki Igakkaishi 23(4) : 265-270, 1997
