Neurogenic stunned myocardium following acute brain injury presents as transient left ventricular dysfunction, ECG changes, and elevated cardiac enzymes, carrying a good prognosis if recognized early.
Neurogenic stunned myocardium following subarachnoid hemorrhage mimics myocardial infarction but is transient and has a good prognosis with appropriate supportive care.
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.
Murthy et al. (Thu,) conducted a review in Neurogenic stunned myocardium following acute subarachnoid hemorrhage. Neurogenic stunned myocardium following acute brain injury presents as transient left ventricular dysfunction, ECG changes, and elevated cardiac enzymes, carrying a good prognosis if recognized early.