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Neurogenic Cardiac Injury.
Nader M. Banki1, Jonathan G. Zaroff
1UCSF Medical Center, Division of Cardiology, 505 Parnassus Avenue, M1177, San Francisco, CA 94143, USA. zaroff@medicine.ucsf.edu
Current Treatment Options in Cardiovascular Medicine
|October 25, 2003
Summary
Subarachnoid hemorrhage (SAH) can cause cardiac injury, but this damage is often reversible. Prioritize treating the brain injury, as cardiac function may improve.
Area of Science:
- Neurology
- Cardiology
- Neurocritical Care
Background:
- Cardiac injury is a known complication of various brain injuries.
- Subarachnoid hemorrhage (SAH) is a frequently studied cause of neurocardiogenic injury.
- Left ventricular (LV) dysfunction and elevated troponin levels are common in SAH patients.
Purpose of the Study:
- To investigate the role of cardiac evaluation in patients with SAH.
- To determine the prognostic and therapeutic value of echocardiography in SAH.
- To assess the necessity of cardiac catheterization in SAH patients with cardiac dysfunction.
Main Methods:
- Echocardiography for prognostication and treatment guidance when LV dysfunction or elevated troponin is present.
- Clinical assessment focusing on the primary neurological condition.
- Cardiac evaluation in brain death cases to potentially expand the donor pool.
Main Results:
- Echocardiography can aid in prognostication and treatment planning for SAH.
- Cardiac catheterization is not routinely recommended for SAH patients with LV dysfunction and elevated troponin.
- Cardiac injury following SAH is generally reversible.
- Cardiac evaluation in brain death may increase organ donor availability.
Conclusions:
- Treatment of the underlying neurological condition is paramount in SAH patients, even with coexisting LV dysfunction.
- Cardiac dysfunction associated with SAH is typically reversible.
- Cardiac assessment in brain death scenarios can benefit organ donation efforts.