Subarachnoid haemorrhage (SAH) presenting with neurogenic cardiac dysfunction is a common entity. Primary cardiac dysfunction and acute ST-elevation myocardial infarction in a patient with subarachnoid haemorrhage is very rare. Differentiating primary cardiac dysfunction and secondary cardiac dysfunction is of prime importance when treating a patient with SAH, as the focus of treatment intervention should be on the primary event. Here, we report a rare case of SAH and high lateral wall myocardial infarction in a patient who succumbed to the disease process due to severe cardiac dysfunction and rebleeding. © 2023 Elsevier B.V., All rights reserved.