Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage

Santosh B. Murthy, Shreyansh Shah, Chethan P Venkatasubba Rao, Eric M. Bershad, Jose Suarez

Research output: Contribution to journalReview article

Abstract

Neurogenic stunned myocardium (NSM) is a triad of transient left ventricular dysfunction, electrocardiogram changes, and elevation in cardiac enzymes, often mimicking a myocardial infarction. It has been described following acute brain injury. The purported mechanism is catecholamine excess resulting in cardiac dysfunction. From the clinical standpoint, the most frequently encountered electrocardiographic changes are QTc prolongation and ST-T changes, with modest elevations in troponin levels. Basal and mid-ventricular segments of the left ventricle are most commonly involved. NSM poses therapeutic challenges when it occurs secondary to aneurysmal subarachnoid hemorrhage, particularly in the setting of coexisting vasospasm. Overall, NSM carries good prognosis if recognized early, with appropriate management of hemodynamic and cardiopulmonary parameters.

Original languageEnglish (US)
Pages (from-to)318-325
Number of pages8
JournalJournal of Intensive Care Medicine
Volume30
Issue number6
DOIs
Publication statusPublished - Jan 1 2015
Externally publishedYes

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Keywords

  • myocardial stunning
  • neurogenic stunned myocardium
  • subarachnoid hemorrhage
  • Takotsubo cardiomyopathy

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

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