蛛网膜下腔出血(SAH)合并急性心肌梗塞(AMl)尤其合并无痛性心肌梗塞的报告罕见。现报告1例: 病例男性,61岁,于活动时突然意识不清,15分钟清醒后诉头痛剧烈、呕吐。检查:神清,血压22.7/13Kpa,瞳孔等大,对光反射存在,双鼻唇沟对称,颈硬,心音低钝,律齐,四肢肌力正常。脑膜刺激征阳性,未引出病理神经反射。次日脑CT诊 Subarachnoid hemorrhage (SAH) combined with acute myocardial infarction (AMl), especially with painless myocardial infarction is rare. Now report 1 case: male, 61 years old, suddenly unconsciousness in the activity, 15 minutes after awake, complained of severe headache, vomiting. Check: God clear, blood pressure 22.7 / 13Kpa, pupils and other large, the presence of light reflex, double nasolabial fold symmetry, neck stiffness, low heart sound blunt, law Qi, muscle strength normal. Meningeal irritation positive, did not lead to pathological nerve reflex. The next day brain CT diagnosis