• J Intensive Care Med · Sep 2015

    Review

    Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations.

    • Santosh B Murthy, Shreyansh Shah, Rao Chethan P Venkatasubba CP Department of Vascular Neurology and Neurocritical Care, Baylor College of Medicine, Houston, TX, USA., Eric M Bershad, and Jose I Suarez.
    • Department of Vascular Neurology and Neurocritical Care, Baylor College of Medicine, Houston, TX, USA santoshbmurthy@gmail.com.
    • J Intensive Care Med. 2015 Sep 1; 30 (6): 318-25.

    AbstractNeurogenic stunned myocardium (NSM) is a triad of transient left ventricular dysfunction, electrocardiogram changes, and elevation in cardiac enzymes, often mimicking a myocardial infarction. It has been described following acute brain injury. The purported mechanism is catecholamine excess resulting in cardiac dysfunction. From the clinical standpoint, the most frequently encountered electrocardiographic changes are QTc prolongation and ST-T changes, with modest elevations in troponin levels. Basal and mid-ventricular segments of the left ventricle are most commonly involved. NSM poses therapeutic challenges when it occurs secondary to aneurysmal subarachnoid hemorrhage, particularly in the setting of coexisting vasospasm. Overall, NSM carries good prognosis if recognized early, with appropriate management of hemodynamic and cardiopulmonary parameters. © The Author(s) 2013.

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