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

Publication ,  Journal Article
Murthy, SB; Shah, S; Rao, CPV; Bershad, EM; Suarez, JI
Published in: J Intensive Care Med
September 2015

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.

Duke Scholars

Published In

J Intensive Care Med

DOI

EISSN

1525-1489

Publication Date

September 2015

Volume

30

Issue

6

Start / End Page

318 / 325

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Subarachnoid Hemorrhage
  • Myocardium
  • Myocardial Stunning
  • Humans
  • Emergency & Critical Care Medicine
  • Electrocardiography
  • 3202 Clinical sciences
  • 1110 Nursing
  • 1103 Clinical Sciences
 

Citation

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ICMJE
MLA
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Murthy, S. B., Shah, S., Rao, C. P. V., Bershad, E. M., & Suarez, J. I. (2015). Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations. J Intensive Care Med, 30(6), 318–325. https://doi.org/10.1177/0885066613511054
Murthy, Santosh B., Shreyansh Shah, Chethan P Venkatasubba Rao, Eric M. Bershad, and Jose I. Suarez. “Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations.J Intensive Care Med 30, no. 6 (September 2015): 318–25. https://doi.org/10.1177/0885066613511054.
Murthy SB, Shah S, Rao CPV, Bershad EM, Suarez JI. Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations. J Intensive Care Med. 2015 Sep;30(6):318–25.
Murthy, Santosh B., et al. “Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations.J Intensive Care Med, vol. 30, no. 6, Sept. 2015, pp. 318–25. Pubmed, doi:10.1177/0885066613511054.
Murthy SB, Shah S, Rao CPV, Bershad EM, Suarez JI. Neurogenic Stunned Myocardium Following Acute Subarachnoid Hemorrhage: Pathophysiology and Practical Considerations. J Intensive Care Med. 2015 Sep;30(6):318–325.
Journal cover image

Published In

J Intensive Care Med

DOI

EISSN

1525-1489

Publication Date

September 2015

Volume

30

Issue

6

Start / End Page

318 / 325

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Subarachnoid Hemorrhage
  • Myocardium
  • Myocardial Stunning
  • Humans
  • Emergency & Critical Care Medicine
  • Electrocardiography
  • 3202 Clinical sciences
  • 1110 Nursing
  • 1103 Clinical Sciences