Mechanisms in neurogenic stress cardiomyopathy after aneurysmal subarachnoid hemorrhage.
Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is often referred to as "neurogenic stunned myocardium," which does not accurately reflect the suspected pathophysiology. We propose an alternative terminology, "neurogenic stress cardiomyopathy," as a more appropriate label based on our review of the current literature. This article will review the distinctive characteristics of SAH-induced cardiac dysfunction, hypotheses to explain the pathophysiology, and the supporting clinical and animal studies. Recognition of the unique features associated with SAH-induced cardiac complications allows optimal management of patients with SAH. We will also discuss the clinical and theoretical overlap of SAH-induced cardiac dysfunction with a syndrome known as tako-tsubo cardiomyopathy and explore therapeutic opportunities.
Lee
Vivien H
VH
Division of Critical Care Neurology, Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Oh
Jae K
JK
Mulvagh
Sharon L
SL
Wijdicks
Eelco F M
EF
D000818:Animals; D009202:Cardiomyopathies / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D007427:Intracranial Pressure / Q000502:physiology; D017682:Myocardial Stunning / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D009638:Norepinephrine / Q000097:blood; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D013577:Syndrome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy
D009638:Norepinephrine