• Seby John, Rula A Hajj-Ali, David Min, Leonard H Calabrese, Russell Cerejo, and Ken Uchino.
• Cerebrovascular Center, Cleveland Clinic, OH, USA.
• Cephalalgia. 2015 Jun 1; 35 (7): 631-4.

BackgroundSystemic vascular alterations have not been described in reversible cerebral vasoconstriction syndrome (RCVS). We present a case series of RCVS patients having cardiac dysfunction during ictus, with a subset showing complete resolution of cardiomyopathy.MethodsRetrospective case-series: Cardiac left ventricular ejection fraction (LVEF) and wall motion abnormalities (WMA) visualized on transthoracic echocardiography (TTE), performed during RCVS ictus and follow-up was analyzed.ResultsOf 68 patients, 18 (26%) had a TTE performed around ictus. Three of 18 (17%) patients demonstrated WMA on initial TTE. All three patients were female without previous coronary artery disease or heart failure, and were asymptomatic from the cardiac dysfunction. WMA resolved completely on follow-up in Patients 1 and 2. Global LV dysfunction persisted for at least 90 days in Patient 3.ConclusionAlthough the exact pathophysiology of the cardiomyopathy is uncertain, it may be related to localized coronary vasoconstriction causing myocardial ischemia/infarction. Vasoconstriction may not be limited to the cerebral vasculature and may involve extracerebral organs. Cardiac ventricular abnormalities may be a part of the RCVS spectrum.© International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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