Epileptic heart: A clinical syndromic approach

Area of Science:

• Cardiology
• Neurology
• Clinical Medicine

Background:

• Premature death in chronic epilepsy patients is a significant challenge.
• Cardiovascular comorbidities are highly prevalent in epilepsy, affecting up to 80% of patients.
• Existing research points to cardiorespiratory mechanisms as key contributors.

Purpose of the Study:

• To introduce and define the concept of an "epileptic heart."
• To propose a novel syndromic approach for early clinical detection of cardiac conditions in epilepsy.
• To review pathophysiologic mechanisms and diagnostic techniques for evaluating cardiac risk in epilepsy.

Main Methods:

• Literature review of pathophysiologic mechanisms linking epilepsy and cardiac dysfunction.
• Evaluation of standard and novel diagnostic techniques including ECG, T-wave alternans, heart rate variability, echocardiography, and biomarkers.
• Proposal of a syndromic approach for clinical assessment.

Main Results:

• The "epileptic heart" is characterized by myocardial infarction, arrhythmia, altered autonomic tone, diastolic dysfunction, hyperlipidemia, and accelerated atherosclerosis.
• Standard and advanced cardiac evaluation methods can identify these changes.
• The proposed syndromic approach facilitates improved monitoring and evaluation of cardiac risk.

Conclusions:

• The "epileptic heart" concept integrates various cardiac pathologies associated with chronic epilepsy.
• A syndromic approach can enhance the clinical detection of cardiac complications.
• Improved cardiac risk assessment may lead to better therapeutic strategies and reduced premature mortality in epilepsy patients.