Cardiovascular Abnormalities and in-Hospital All-Cause Mortality in Patients with Spontaneous Sub-Arachnoid Hemorrhage: An Observational Study

Mahmoud, Ahmed N.; Elgendy, Islam Y.; Mansoor, Hend

doi:10.1007/s40119-016-0076-0

Cited by 4 publications

(2 citation statements)

References 23 publications

(31 reference statements)

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“…3 Hemorrhages, increased intracranial pressure (ICP), midline shift, and subsequent physical compression of the brainstem and hypothalamic autonomic centers can trigger catecholamine responses that could instigate arrhythmia in this patient. 2 This means that the arrhythmia in this patient is most probably caused by enhanced automaticity due to systemic catecholamine storm is driven by central neuroendocrine axis. Due to high circulating catecholamine for up to 10 days cardiac dysfunction may persist for a protracted period.…”

Section: Laporan Kasusmentioning

confidence: 83%

A Case Report of Elderly Woman with Supraventricular Tachycardia associated with Intracranial Bleeding

Pranata¹,

Chintya²,

Yonas³

et al. 2017

IJC

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Background The neurogenic cardiac injury is related to brain injury-induced catecholamine and neuro-inflammatory responses and is more likely in those with the most severe neurological insult. Case Report A 78 years-old female presented to the emergency department after being found lying on the floor with a laceration on the head. On physical examination GCS 3, BP 140/90 mmHg, HR 190 bpm, respiratory rate 25x/minute. PMH of hypertension and diabetes were denied. ECG showed supraventricular tachycardia of 186 bpm. Laboratory exams showed hyponatremia, hypokalemia, and leukocytosis. CT scan revealed subarachnoid hemorrhage, intracerebral hematomas, chronic subdural hematoma, midline shift and subfalcine herniation. The systemic catecholamine ‘storm’ driven by the central neuroendocrine axis massively increases sympathetic outflow, activates the adrenal gland and may lead to arrhythmia. Increased ICP, Midline shift, and subsequent physical compression of the brainstem and hypothalamic autonomic centers can trigger catecholamine responses that could instigate an arrhythmia. Suboptimal cardiac output and cerebral perfusion worsen secondary brain injury leading to a worse prognosis. Since cardioversion failed, amiodarone was administered. Cardioversions failed to convert to sinus rhythm and amiodarone was administered. Therapy to reduce intracranial pressure was also administered. The patient passed away 4 hours after admission. Conclusion Arrhythmia related to brain injury may lead to suboptimal cerebral perfusion and leads to further autonomic derangements leading to a vicious cycle of cerebral and cardiovascular injuries. This condition should be accounted for swiftly to prevent secondary brain injuries and myocardial ischemia. Abstrak Latar Belakang Respons katekolamin dan radang terhadap cedera otak menyebabkan cedera jantung neurogenik yang lebih sering terjadi pada kerusakan neurologis yang berat. Laporan Kasus Seorang perempuan 78 tahun datang ke IGD setelah ditemukan tergeletak di lantai dengan robek pada kulit kepala. Pada pemeriksaan fisik ditemukan GCS 3, TD 140/90 mmHg, detak jantung 190 kali/menit, laju pernafasan 25 kali/menit. Riwayat hipertensi dan diabetes disangkal. EKG menunjukan takikardia supraventrikular takikardi 186 kali/menit. Pemeriksaan laboratorium menunjukan hiponatremia, hipokalemia dan leukositosis. CT scan menunjukan perdarahan subaraknoid, perdarahan intraserebral, perdarahan subdural kronis, midline shift dan herniasi subfalcine. Badai katekolamin sistemik yang dicetuskan oleh aksis neuroendokrin pusat meningkatkan outflow simpatetik yang mengaktifkan kelenjar adrenal dan menyebabkan aritmia. Peningkatan tekanan intrakranial, midline shift, dan penekanan batang otak serta pusat autonomik hipotalamus dapat mencetuskan respon katekolamin yang dapat menyebabkan aritmia. Curah jantung yang tidak optimal dan perfusi otak yang buruk menyebabkan cedera otak sekunder yang mengarah pada prognosis yang buruk. Karena kardioversi gagal merubah irama menjadi sinus maka amiodaron diberikan. Pengobatan untuk menurunkan tekanan intrakranial juga diberikan. Pasien meninggal 4 jam setelah masuk rumah sakit. Kesimpulan Aritmia yang berhubungan dengan cedera otak dapat menyebabkan perfusi otak yang suboptimal serta menyebabkan ketidakteraturan otonom dan menyebabkan lingkaran setan kerusakan otak dan jantung-pembuluh darah. Hal ini harus segera ditangani untuk mencegah cedera otak sekunder dan iskemi miokardial.

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Section: Laporan Kasusmentioning

confidence: 83%

A Case Report of Elderly Woman with Supraventricular Tachycardia associated with Intracranial Bleeding

Pranata¹,

Chintya²,

Yonas³

et al. 2017

IJC

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“…Elevation of cardiac injury markers is common after SAH. ECG changes have been reported in about two thirds of SAH hospitalized patients; 55 , 56 the most common changes were prolonged QT interval followed by T waves inversion and ST depression or elevation, 55 - 57 and they predicted higher in-hospital mortality. 56 Besides, cardiac troponin was increased in 30% of patients with SAH and was associated with an increased risk of in-hospital mortality and 12-month deaths.…”

Section: Introductionmentioning

confidence: 99%

Brain, heart, and sudden death

Oveisgharan¹,

Ghaffarpasand²,

Sörös³

et al. 2022

CJN

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During the past 30 years, rate of coronary artery disease (CAD), as the main cause of sudden death (SD), has decreased more than rate of SD. Likewise, cause of SD remains elusive in not a trivial portion of its victims. One possible reason is attention to only one organ, the heart, as the cause of SD. In fact, SD literature focuses more on the heart, less on the brain, and seldom on both. A change is required. In this paper, we first review the pathological findings seen in heart autopsies of SD victims after psychological stressors such as physical assault victims without internal injuries. Then, we summarize new studies investigating brain areas, like the insula, whose malfunctions and injuries are related to SD. Next, we review prototypes of neurological diseases and psychological stressors associated with SD and look at heart failure (HF)-related SD providing evidence for the brain-heart connection. Finally, we propose a new look at SD risk factors considering both brain and heart in their association with SD, and review strategies for prevention of SD from this perspective.

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Electrocadiographic Scoring Helps Predict Left Ventricular Wall Motion Abnormality Commonly Observed after Subarachnoid Hemorrhage

Sugimoto

Yamada

Inamasu

et al. 2018

Journal of Stroke and Cerebrovascular Diseases

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Cardiovascular Abnormalities and in-Hospital All-Cause Mortality in Patients with Spontaneous Sub-Arachnoid Hemorrhage: An Observational Study

Cited by 4 publications

References 23 publications

A Case Report of Elderly Woman with Supraventricular Tachycardia associated with Intracranial Bleeding

A Case Report of Elderly Woman with Supraventricular Tachycardia associated with Intracranial Bleeding

Brain, heart, and sudden death

Electrocadiographic Scoring Helps Predict Left Ventricular Wall Motion Abnormality Commonly Observed after Subarachnoid Hemorrhage

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