Cardiovascular and Pulmonary Complications of Aneurysmal Subarachnoid Hemorrhage

Bruder, N.; Rabinstein, Alejandro A.

doi:10.1007/s12028-011-9598-4

Cited by 87 publications

(43 citation statements)

References 74 publications

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“…Elevation of serum myocardial enzymes is reported in 11–21% of SAH patients and in 1–17% of ischemic stroke patients 35 . SAH patients have higher levels of circulating high-sensitivity Troponin T (hsTnT) and N-terminal fragment of B-type natriuretic peptide (NTproBNP) 36, 37 . 22% of brain hemorrhage patients have Troponin I elevation and 59% have NT-proBNP elevation 38 .…”

Section: Cardiac Damage As a Consequence Of Strokementioning

confidence: 99%

Brain–Heart Interaction

Chen

Venkat

Seyfried

et al. 2017

Circulation Research

417

202

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Neurocardiology is an emerging specialty that addresses the interaction between the brain and the heart, i.e. the effects of cardiac injury on the brain, and the effects of brain injury on the heart. This review article focuses on cardiac dysfunction in the setting of stroke such as ischemic stroke, brain hemorrhage and subarachnoid hemorrhage (SAH). The majority of post stroke deaths are attributed to neurological damage, and cardiovascular complications are the second leading cause of post stroke mortality. Accumulating clinical and experimental evidence suggests a causal relationship between brain damage and heart dysfunction. Thus, it is important to determine whether cardiac dysfunction is triggered by stroke, is an unrelated complication, or is the underlying cause of stroke. Stroke induced cardiac damage may lead to fatality or potentially lifelong cardiac problems (such as heart failure), or to mild and recoverable damage such as neurogenic stress cardiomyopathy (NSC) and Takotsubo cardiomyopathy. The role of location and lateralization of brain lesions after stroke in brain-heart interaction, clinical biomarkers and manifestations of cardiac complications, and underlying mechanisms of brain-heart interaction following stroke, such as: the hypothalamic pituitary adrenal axis (HPA); catecholamine surge; sympathetic and parasympathetic regulation; microvesicles (MV’s); microRNAs; gut microbiome, immunoresponse and systemic inflammation are discussed.

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Section: Cardiac Damage As a Consequence Of Strokementioning

confidence: 99%

Brain–Heart Interaction

Chen

Venkat

Seyfried

et al. 2017

Circulation Research

417

202

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“…The combination of hypotension and vasomotor instability also has been described as a result of medullary stroke or arteriovenous fistula in the medulla 10 11. Neurogenically caused cardiac arrhythmias as a result of stroke or cerebral haemorrhage, especially subarachnoid haemorrhage have been described extensively 12. However, the occurrence of arrhythmias have been also reported in isolated brain stem lesions 13…”

Section: Discussionmentioning

confidence: 99%

Distributive shock, cardiac arrhythmias and multiple organ failure following surgery of a fourth ventricular epidermoid

Bercker¹,

Meixensberger

Laudi³

et al. 2016

BMJ Case Reports

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A 33-years-old male patient presented with cardiac arrhythmias, acute shock and multiple organ dysfunction after the surgical removal of a massive epidermoid posterior to the brainstem. The patient initially presented with paraesthesia along the right C6 dermatome due to a big tumour at the brain stem. Surgical removal was performed without adverse events and he was transferred to our intensive care unit (ICU) immediately after the operation. Though initially showing a stable postsurgical course he developed cardiac arrhythmias and a state of acute distributive shock with consecutive multi organ failure. Extensive diagnostic measures could not identify a specific cause for this rapid deterioration. However, under carefully monitored symptomatic therapy the patient improved quickly, was extubated 72 h after admission and discharged from the ICU 6 days later. The follow-up did not show any persisting neurological deficits and no evidence of a residual tumour in the MRI-study.

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“…Autonomic dysregulation after stroke has been linked to sudden blood pressure fluctuations, hypertensive crises, tachyarrhythmias, direct myocardial damage, neurogenic stunned myocardium or neurogenic pulmonary edema [8,[27][28][29]. Sympathetically driven inflammation, hyperglycemia, and increased BBB permeability may contribute to brain edema and secondary brain injury [30,31].…”

Section: Discussionmentioning

confidence: 99%