Neurogenic Stunned Myocardium: A Narrative Review of Cardiopulmonary Failure Related to Subarachnoidal Haemorrhage

TL;DR

This paper reviews how brain bleeding from subarachnoid hemorrhage can lead to heart failure and explores the underlying mechanisms.

Contribution

The paper provides a comprehensive narrative review of the current understanding of cardiac failure mechanisms following subarachnoid hemorrhage.

Findings

SAH can lead to acute cardiac failure with high morbidity and mortality.

Two forms of cardiac failure are described: neurogenic stunned myocardium and takotsubo cardiomyopathy.

The pathophysiology remains incompletely understood but is an active area of research.

Abstract

Acute subarachnoid haemorrhage (SAH) is an acute bleeding in the subarachnoid space in the brain. Due to various pathophysiological sequelae, SAH can be accompanied by acute cardiac failure. Patients who suffer from cardiac failure due to SAH have a high morbidity and mortality. Although the pathophysiology is not completely understood in both clinical and experimental studies, several attempts have been made and published to explain the pathophysiological mechanisms of cardiac failure in SAH patients. Two forms of cardiac failure are described after neurologic injury (like SAH) which are neurogenic stunned myocardium (NSM) with or without diffuse and/or regional wall motion abnormalities (RWMA), and a more specific form called takotsubo cardiomyopathy. This review aims to summarise the current literature on cardiac abnormalities and related pathophysiology in patients with SAH.

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