Aneurysmal subarachnoid hemorrhage as a trigger for Takotsubo syndrome: a comprehensive review

Wagner, Sibylle; Güthe, Thomas; Bhogal, Pervinder; Cimpoca, Alexandru; Ganslandt, Oliver; Bäzner, Hansjörg; Henkes, Hans

doi:10.31083/j.rcm2204132

Cited by 10 publications

(16 citation statements)

References 96 publications

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“…During an acute neurologic event, activation of the medullary autonomic center leads to a massive release of both norepinephrine and epinephrine. The effect of norepinephrine on the basal segments of the myocardium via direct cardiac sympathetic nerve fiber simulation is hypothesized to play a greater role than adrenally released epinephrine in the pathophysiology if neurogenic Takotsubo cardiomyopathy [ 9 ]. The positive inotropic effect of direct sympathetic stimulation by norepinephrine leads to the significant basal hyperkinesis observed on echocardiography [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The effect of norepinephrine on the basal segments of the myocardium via direct cardiac sympathetic nerve fiber simulation is hypothesized to play a greater role than adrenally released epinephrine in the pathophysiology if neurogenic Takotsubo cardiomyopathy [ 9 ]. The positive inotropic effect of direct sympathetic stimulation by norepinephrine leads to the significant basal hyperkinesis observed on echocardiography [ 9 ]. However, the pathophysiology of neurogenic Takotsubo cardiomyopathy is controversial.…”

Section: Discussionmentioning

confidence: 99%

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Takotsubo Cardiomyopathy Secondary to Cryptococcal Meningoencephalitis in a Patient With Multiple Sclerosis

et al. 2022

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Takotsubo or stress-induced cardiomyopathy is described as reversible left ventricular dysfunction that develops following a stressful emotional or physical event primarily occurring in postmenopausal females. Many physiologic triggers have been identified in the pathogenesis of Takotsubo cardiomyopathy, including diseases which affect the central nervous system such as traumatic brain injuries, hemorrhagic and ischemic strokes, epilepsy, and central nervous system infections, including meningitis and encephalitis; however, there are very few published case reports of Takotsubo cardiomyopathy in the setting of fungal meningoencephalitis. We present a unique case of Takotsubo cardiomyopathy secondary to Cryptococcus neoformans meningoencephalitis in a middle-aged female with a history of multiple sclerosis who was taking immunosuppressive therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Takotsubo Cardiomyopathy Secondary to Cryptococcal Meningoencephalitis in a Patient With Multiple Sclerosis

et al. 2022

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“…169 However, due to the pathophysiologic background of the disease, it is generally recommended that adrenaline, noradrenaline, dobutamine, milrinone, and isoproterenol should be avoided in patients with TTC secondary to neurological illness. 170 On the other hand, if indicated, the use of the inotropes dobutamine and milrinone may improve cardiac function in SAH patients with NSC, with patients with cerebral vasospasm being especially benefited by milrinone. 8,170 Patients with cardiogenic shock without LV outflow tract obstruction (LVOTO) usually present with hypotension.…”

Section: Therapeutic Strategiesmentioning

confidence: 99%

“…170 On the other hand, if indicated, the use of the inotropes dobutamine and milrinone may improve cardiac function in SAH patients with NSC, with patients with cerebral vasospasm being especially benefited by milrinone. 8,170 Patients with cardiogenic shock without LV outflow tract obstruction (LVOTO) usually present with hypotension. For the specific patient group, the use of dobutamine/dopamine is recommended for its treatment due to their positive inotropic effect.…”

Section: Therapeutic Strategiesmentioning

confidence: 99%

The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy—A Review

Ziaka¹,

Exadaktylos

2023

J Stroke

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In recent years, it has been convincingly demonstrated that acute brain injury may cause severe cardiac complications-such as neurogenic stress cardiomyopathy (NSC), a specific form of takotsubo cardiomyopathy. The pathophysiology of these brain-heart interactions is complex and involves sympathetic hyperactivity, activation of the hypothalamic-pituitary-adrenal axis, as well as immune and inflammatory pathways. There have been great strides in our understanding of the axis from the brain to the heart in patients with isolated acute brain injury and more specifically in patients with stroke. On the other hand, in patients with NSC, research has mainly focused on hemodynamic dysfunction due to arrhythmias, regional wall motion abnormality, or left ventricular hypokinesia that leads to impaired cerebral perfusion pressure. Comparatively little is known about the underlying secondary and delayed cerebral complications. The aim of the present review is to describe the stroke-heart-brain axis and highlight the main pathophysiological mechanisms leading to secondary and delayed cerebral injury in patients with concurrent hemorrhagic or ischemic stroke and NSC as well as to identify further areas of research that could potentially improve outcomes in this specific patient population.

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“…A quite robust association between TC and ischemic stroke is undeniable [ 7 ]. In addition, scattered literature describes the possible connivance of TC with other acute neurological disorders such as transient global amnesia [ 8 ], aneurysmal subarachnoid hemorrhage (aSAH) [ 9 ], epileptic seizures [ 10 ]. The true incidence of TC in association with these diseases is unknown.…”

Section: Introductionmentioning

confidence: 99%

The Octopus Trap of Takotsubo and Stroke: Genetics, Biomarkers and Clinical Management

Canavero

Rifino

Bussotti

et al. 2022

JPM

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Takotsubo cardiomyopathy (TC) is a reversible cardiomyopathy mimicking an acute coronary syndrome, usually observed in response to acute stress situations. The association between acute ischemic stroke and TC is already known, since it has been previously reported that ischemic stroke can be both a consequence and a potential cause of TC. However, the precise pathophysiological mechanism linking the two conditions is still poorly understood. The aim of our review is to expand insights regarding the genetic susceptibility and available specific biomarkers of TC and to investigate the clinical profile and outcomes of patients with TC and stroke. Since evidence and trials on TC and stroke are currently lacking, this paper aims to fill a substantial gap in the literature about the relationship between these pathologies.

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Aneurysmal subarachnoid hemorrhage as a trigger for Takotsubo syndrome: a comprehensive review

Cited by 10 publications

References 96 publications

Takotsubo Cardiomyopathy Secondary to Cryptococcal Meningoencephalitis in a Patient With Multiple Sclerosis

Takotsubo Cardiomyopathy Secondary to Cryptococcal Meningoencephalitis in a Patient With Multiple Sclerosis

The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy—A Review

The Octopus Trap of Takotsubo and Stroke: Genetics, Biomarkers and Clinical Management

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