Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations.

Journal Article (Journal Article;Review)

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.

Full Text

Duke Authors

Cited Authors

  • Murthy, SB; Shah, S; Rao, CPV; Bershad, EM; Suarez, JI

Published Date

  • September 2015

Published In

Volume / Issue

  • 30 / 6

Start / End Page

  • 318 - 325

PubMed ID

  • 24212600

Electronic International Standard Serial Number (EISSN)

  • 1525-1489

Digital Object Identifier (DOI)

  • 10.1177/0885066613511054


  • eng

Conference Location

  • United States