Summary: Cardiac complications are well known after an-

eurysmal subarachnoid hemorrhage. Electrocardiographic changes occur in 50 % to 100 % of such cases. Arrhythmias, left ventricular dysfunction, and frank myocardial infarc-tion are infrequently observed. Myocardial infarction must be differentiated from neurogenic stunned myocardium, which is a reversible condition. From 1996 to 2001, 105 patients with aneurysmal subarachnoid hemorrhage un-derwent endovascular treatment at the University of Mich-igan. Of these, four patients with no history of cardiac disease experienced cardiac failure related to neurogenic stunned myocardium. All had signs of left ventricular dys-function, electrocardiographic changes, and elevated car-diac enzymes. Three had pulmonary edema at presentation. All were diagnosed with myocardial infarction. One under-went coronary angiography, which was normal. All wer