Left ventricular wall motion abnormalities in subarachnoid hemorrhage: an echocardiographic study

Area of Science:

• Cardiology
• Neurology
• Critical Care Medicine

Background:

• Electrocardiographic (ECG) abnormalities and autopsy findings suggest cardiac involvement in subarachnoid hemorrhage (SAH).
• The relationship between SAH and in vivo left ventricular (LV) function has not been well-established.

Purpose of the Study:

• To investigate left ventricular function using echocardiography in patients with SAH.
• To correlate cardiac function with neurological status and biochemical markers.

Main Methods:

• Two-dimensional echocardiography was performed serially on 13 SAH patients within 14 days of admission.
• Serum creatine kinase (total and myocardial isoenzyme) and ECGs were monitored regularly.
• Neurologic state was assessed using a standard grading system.

Main Results:

• Four patients (Group I) showed LV wall motion abnormalities and elevated myocardial isoenzymes.
• Group I patients had higher heart rates, more severe neurologic grades, and more frequent inverted T waves on ECG.
• Three of four Group I patients died; autopsies revealed no significant coronary artery disease.

Conclusions:

• SAH is associated with significant LV dysfunction, even without coronary artery disease.
• LV dysfunction in SAH is linked to adverse neurological outcomes and increased mortality.
• Echocardiography and cardiac enzyme monitoring are crucial for assessing cardiac risk in SAH patients.