Why the study?
Treatment options for patients with brain injury progressing to cardiogenic shock remain controversial with no consistent guidelines, especially in the setting of subarachnoid hemorrhage with concurrent cerebral vasospasm.
Neurogenic stunned myocardium is a reversible but potentially life-threatening condition requiring prompt recognition and complex management, particularly in the setting of subarachnoid hemorrhage and cardiogenic shock.
May warrant prompt recognition in neurocritical care; leaves open prospective trials to define optimal management.
Neurogenic stunned myocardium is a form of stress cardiomyopathy. The disorder is sometimes referred to as atypical Takotsubo cardiomyopathy. The pathophysiology of neurogenic stunned myocardium is hypothesized to involve significant overdrive of the sympathetic nervous system after a brain injury. Treatment options for a patient with a brain injury who has progressed to cardiogenic shock remain controversial, with no consistent guidelines. A patient with subarachnoid hemorrhage who progresses to cardiogenic shock with concurrent cerebral vasospasm presents a special treatment challenge. Neurogenic stunned myocardium is reversible; however, it must be recognized immediately to avoid or manage potential complications, such as cardiogenic shock and pulmonary edema. A multifaceted treatment approach is needed for the patient with cardiogenic shock and concurrent vasospasm.
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Stoddard et al. (2021) studied this question.
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