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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
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Cardiogenic shock associated with subarachnoid hemorrhage
Glauco Adrieno Westphal1, Gerson Costa, Sérgio Gouvêa
1Hospital Municipal São José, Joinville, SC, Brasil.
Revista Brasileira De Terapia Intensiva
|October 11, 2014
Summary
Subarachnoid hemorrhage can cause myocardial dysfunction and cardiogenic shock, mimicking heart attacks. Prompt diagnosis and hemodynamic stabilization are crucial for improving outcomes and reducing cerebral ischemia risk.
Area of Science:
- Neurology
- Cardiology
- Critical Care Medicine
Background:
- Systemic complications are common in subarachnoid hemorrhage (SAH) patients.
- Electrocardiographic abnormalities mimicking ischemic cardiomyopathy can occur, linked to myocardial dysfunction.
Purpose of the Study:
- To report a case of SAH associated with myocardial dysfunction and cardiogenic shock.
- To highlight the importance of diagnosis and hemodynamic management in such cases.
Main Methods:
- Case report of a 45-year-old female with SAH, coma, and subsequent cardiogenic shock.
- Inclusion of diagnostic tests: ECG, cardiac enzymes, cardiac index, systemic vascular resistance, ejection fraction, coronariography, and transcranial Doppler.
- Management involved aneurysm embolization, respiratory support, and dobutamine infusion.
Main Results:
- The patient presented with SAH, coma, pulmonary infiltration, dyspnea, hypotension, ECG changes, and elevated CK-MB.
- Cardiogenic shock was diagnosed based on low cardiac index and unresponsiveness to volume.
- Coronary angiography was normal; ejection fraction improved from 39% to 65% after treatment.
Conclusions:
- SAH can lead to ventricular dysfunction and cardiogenic shock, increasing cerebral ischemia risk.
- Optimizing diagnosis and hemodynamic stabilization are essential for managing SAH complications.
- Early intervention can improve cardiac function and reduce secondary neurological injury.
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