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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 December;164(6):445-50

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: English

Subarachnoid hemorrhage and the heart. A review

Lamaida E. ¹, Lamaida N. ², Pizza V. ³, Volpe G. ³, Graziussi G. ¹

¹ Division of Neurosurgery, Vallo della Lucania, Department of Neuro-ortho-traumatology, ASL 3-Vallo della Lucania, Salerno; ² Nursing home Malzoni, Agropoli, Department of Neuro-ortho-traumatology, ASL 3-Vallo della Lucania, Salerno; ³ Division of Neurophysiopathology, Vallo della Lucania, Department of Neuro-ortho-traumatology, ASL 3-Vallo della Lucania, Salerno

Electrocardographic abnormalities and rhythm disorders are frequently observed in the acute phase after spontaneous subarachnoid hemorrhage. There abnormalities are benign and transient in most cases. However, approximately 25% of patients with subarachnoid hemorrhage have electrocardiographic alterations consistent with myocardial infarction, and their cardiac prognosis remains unclear. The pathophysiology of these abnormalities is related to an imbalance of the autonomic cardiovascular control and to increased circulating and local myocardial tissue cathecolamines. Neurological status is the most important determinant of outcome and death is usually the direct result of the brain injury. Whereas cardiac dysfunction is not a direct cause of mortality after subarachnoid hemorrhage, it may increase morbidity because of arrhythmias or pulmonary oedema.