Cardiac Dysfunction in Neurocritical Care: An Autonomic Perspective

A number of neurologic disorders can cause cardiac dysfunction by involving the conductive system and contractile apparatus of the heart. This is especially prominent in the neurocritical care setting where the spectrum of cardiac dysfunction due to acute neurologic injury ranges from trivial and is...

Full description

Saved in:
Bibliographic Details
Published in:Neurocritical care 2019-06, Vol.30 (3), p.508-521
Main Authors: Ibrahim, Mohammad S., Samuel, Bennson, Mohamed, Wazim, Suchdev, Kushak
Format: Article
Language:English
Subjects:
Anesthesia
Arrhythmias, Cardiac - diagnosis
Arrhythmias, Cardiac - physiopathology
Arrhythmias, Cardiac - therapy
Autonomic Nervous System Diseases - diagnosis
Autonomic Nervous System Diseases - physiopathology
Autonomic Nervous System Diseases - therapy
Cardiomyopathies - diagnosis
Cardiomyopathies - physiopathology
Cardiomyopathies - therapy
Catecholamines
Coronary vessels
Critical Care
Critical Care Medicine
Death, Sudden, Cardiac
Heart
Heart Arrest - diagnosis
Heart Arrest - physiopathology
Heart Arrest - therapy
Humans
Hypothalamus
Intensive
Internal Medicine
Medicine
Medicine & Public Health
Nervous system
Neurology
Pathophysiology
Review
Spinal cord
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A number of neurologic disorders can cause cardiac dysfunction by involving the conductive system and contractile apparatus of the heart. This is especially prominent in the neurocritical care setting where the spectrum of cardiac dysfunction due to acute neurologic injury ranges from trivial and isolated electrocardiographic changes to malignant arrhythmias and sudden death (Table  1 ). The mechanism of these cardiac complications is complex and not fully understood. An understanding of the neuroanatomical structures and pathways is of immense importance to comprehend the underlying pathophysiology that culminates as cardiac damage and dysregulation. Once the process is initiated, it can complicate and adversely affect the outcome of primary neurologic conditions commonly seen in the neurocritical care setting. Not only are these cardiac disorders under-recognized, there is a paucity of data to formulate evidence-based guidelines regarding early detection, acute management, and preventive strategies. However, certain details of clinical features and their course combined with location of primary neurologic lesion on neuroimaging and data obtained from laboratory investigations can be of great value to develop a strategy to appropriately manage these patients and to prevent adverse outcome from these cardiac complications. In this review, we highlight the mechanisms of cardiac dysfunction due to catastrophic neurologic conditions or due to stress of critical illness. We also address various clinical syndromes of cardiac dysfunction that occur as a result of the neurologic illness and in turn may complicate the course of the primary neurologic condition.
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-018-0636-3