Subarachnoid hemorrhage and the heart.

Area of Science:

• Cardiology
• Neurology
• Autonomic Nervous System

Context:

• Spontaneous subarachnoid hemorrhage (SAH) is frequently associated with electrocardiographic (ECG) abnormalities.
• These cardiac changes often indicate subendocardial damage.
• The underlying mechanism involves hypothalamic stimulation and increased sympathetic tone.

Purpose:

• To review the causes and types of cardiac abnormalities following SAH.
• To explore the relationship between these abnormalities and subendocardial lesions.
• To examine the role of autonomic blockers in managing these conditions.

Summary:

• SAH can trigger potentially life-threatening ventricular arrhythmias due to acute sympathetic nervous system activation.
• Sympathetic blocking agents have shown efficacy in treating these arrhythmias and may protect subendocardial tissue.
• However, prophylactic use of autonomic blockers like propranolol has not demonstrated improved patient outcomes.

Impact:

• Understanding the cardiac manifestations of SAH is crucial for patient management.
• Further research into the role of the autonomic nervous system in SAH-related cardiac events is warranted.
• Morbidity and mortality in SAH are primarily linked to the severity of intracranial hemorrhage and vasospasm.