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Abstract
Computerized tomography (CT) scan and digital subtraction angiography (DSA) of his brain showed sub-arachnoid haemorrhage (SAH) and anterior communicating artery aneurysm respectively. Repeat CT scan did not show any new abnormality but transcranial Doppler (TCD) study showed increased mean flow velocities in bilateral anterior cerebral arteries (ACAs). The ST segment depression in our patient could have been due to reduction of coronary blood flow (which is dependent on diastole and DBP) causing sub-endocardial ischaemia.