Incidence of Cardiac Dysfunction After Brain Injury

Abstract

Introduction:Cardiovascular complications in patients with subarachnoid hemorrhage are considered to be a neurally mediated process rather than a manifestation of coronary artery disease.Aim:The aim of study is to show the incidence and type cardiac complications after traumatic and spontaneous SAH.Patients and methods:The study had prospective character in which included 104 patients, with diagnosed subarachnoid hemorrhage (SAH), in the period from 2014 to 2017. Two groups of patients were formed. Group I: patients with SAH caused by the rupture of a brain aneurysm. Group II: patients with SAH after traumatic brain injury.Results:Electrocardiogram (ECG) abnormalities was predominant after traumatic brain injury 74 %, with statistically significant difference atrial fibrillation 42.5 % (p = 0.043) and sinus bradycardia 31.4 % (p = 0.05). Hypertension are predominant in patients with spontaneous SAH with statistically significant difference (15 (27.7%) vs 36 (72%) p=0.034) and hypotension in group II (10 (18.5%) vs 2 (4%) p = 0.021 ) with traumatic SAH patients. The time in Intensive Care Unit (ICU) for traumatic SAH group was 6.1 ± 5.2 days and 3.9 ± 1.16 for spontaneous SAH group with statistical significance (p = 0.046). Respiratory support time was longer in traumatic SAH group (39.4 ± 23.44 vs. 15.66 ± 22.78) with p = 0.043.Conclusion:Cardiac dysfunction in patients with subarachnoid hemorrhage are considered to be a neurally mediated process rather than a manifestation of coronary artery disease. Early treatment of cerebral injury could be reduce incidence of cardiac complications after traumatic brain injury. Cardiac dysfunction in patients with SAH is still very high, despite substantial qualitative progress in their treatment.

Decompressive Craniectomy Improves QTc Interval in Traumatic Brain Injury Patients

“…Cardiac disorders related to the central nervous system have been studied for several years, and many pathomechanisms have been suggested to explain such relationships [ 3 , 4 , 5 , 6 , 26 ]. Each kind of brain injury induces massive catecholamine release and disturbs cardiac autonomic balance via increasing sympathetic activity [ 27 , 28 ].…”

“…Common cardiological consequences of TBI include myocardial ischemia, diminished cardiac contractility and electrocardiographic (ECG) abnormalities including cardiac arrhythmias [ 2 , 3 ]. ECG abnormalities such as ST segment depression or elevation, T-wave inversion, new Q waves, prolonged PR and corrected QT (QTc) intervals occur in more than 50% of patients with severe TBI [ 1 , 2 , 3 , 4 , 5 ]. Recently, we documented a significant increase in the spatial QRS-T angle (spQRS-T) and prolongation of the QTc interval within the first 24 and 48 h after moderate or severe TBI [ 6 ].…”

Distant Organ Damage in Acute Brain Injury

“…Cardiac dysfunction in brain injury is a relatively common and clinically significant condition. It is noticed to occur in 13–74% patients with traumatic brain injury (TBI) [ 51 , 52 , 53 , 54 , 55 ]. According to recent studies, 69% of patients with SAH present with an abnormal admission ECG [ 52 ].…”