title: The link between intracranial haemorrhage and cardiogenic shock: a case of Takotsubo cardiomyopathy.
abstract: Myocardial dysfunction occurs frequently during subarachnoid haemorrhage (SAH) and it is often referred to as neurogenic stunned myocardium (NSM). Takotsubo cardiomyopathy (TTC), which can lead to life-threatening acute heart failure, has been considered a possible complication of SAH. Actually, NSM and TTC are believed to share the same pathophysiological mechanisms and are likely a manifestation of the same disease. We report a case of a 64-year-old woman with SAH and cardiogenic shock due to acute left ventricular dysfunction. Echocardiography and ventriculography showed the typical pattern of TTC. Angiography excluded coronary artery disease or coronary spasm. Short-term inotropic support was necessary. Rapid recovery of left ventricular function was observed after 8 days. Acute myocardial dysfunction due to TTC in the setting of SAH may lead to cardiogenic shock which is difficult to treat. Patients with SAH and haemodynamic instability warrant a careful assessment of ventricular function on admission to rule out TTC
authors.affiliation: Section of Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Brescia, Brescia, Italy. giorgio.caretta@gmail.com
authors.forename: Giorgio
authors.initials: G
authors.lastname: Caretta
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rovetta
authors.forename: Laura
authors.initials: L
authors.lastname: Evaristi
authors.forename: Filippo
authors.initials: F
authors.lastname: Quinzani
authors.forename: Riccardo
authors.initials: R
authors.lastname: Raddino
authors.forename: Livio
authors.initials: L
authors.lastname: Dei Cas
mesh_terms: D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007442:Intubation, Intratracheal; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000209:etiology*; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis*; D018487:Ventricular Dysfunction, Left / Q000209:etiology*