Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations.

Abstract:

:Neurogenic stunned myocardium (NSM) is a triad of transient left ventricular dysfunction, electrocardiogram changes, and elevation in cardiac enzymes, often mimicking a myocardial infarction. It has been described following acute brain injury. The purported mechanism is catecholamine excess resulting in cardiac dysfunction. From the clinical standpoint, the most frequently encountered electrocardiographic changes are QTc prolongation and ST-T changes, with modest elevations in troponin levels. Basal and mid-ventricular segments of the left ventricle are most commonly involved. NSM poses therapeutic challenges when it occurs secondary to aneurysmal subarachnoid hemorrhage, particularly in the setting of coexisting vasospasm. Overall, NSM carries good prognosis if recognized early, with appropriate management of hemodynamic and cardiopulmonary parameters.

journal_name

J Intensive Care Med

authors

Murthy SB,Shah S,Rao CP,Bershad EM,Suarez JI

doi

10.1177/0885066613511054

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

318-25

issue

6

eissn

0885-0666

issn

1525-1489

pii

0885066613511054

journal_volume

30

pub_type

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