Advanced Biventricular Heart Failure Precipitated by Large Territory Stroke in a Patient With Carvajal Syndrome
Chandu Sadasivan1, Luke R Gagnon1, Chen Hsiang Ma1
1Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Abstract:
Stroke-heart syndrome describes the neurocardiogenic mechanisms that lead to the development of poststroke cardiovascular complications. We describe a 25-year-old man with Carvajal syndrome who developed advanced biventricular heart failure 2 months after a large territory ischemic stroke. His condition was managed with inotropic support initially and required biventricular assist devices as a bridge to possible heart transplantation. This case highlights the increased risk of cardiovascular complications after stroke through dysregulation of the brain-heart axis. Poststroke neuron death leads to systemic and local inflammation through noradrenaline, interleukin-1, and other proinflammatory cells. This cumulatively leads to endothelial dysfunction and cardiomyocyte fibrosis/necrosis within the heart.
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