Cardiovascular and pulmonary complications of aneurysmal subarachnoid hemorrhage.

Cardiopulmonary complications after aneurysmal subarachnoid hemorrhage negatively affect overall morbidity and mortality. An electronic literature search was performed for English-language articles focused on cardiopulmonary complications with subarachnoid hemorrhage published through October 2010. A total of 278 citations were identified, including 72 clinical studies. In most cases, study quality was low or very low. Cardiac injury, evidenced by an elevation in troponin levels, is reported in about one-third of patients after aneurysmal subarachnoid hemorrhage. Arrhythmias also occur in about one-third of patients after subarachnoid hemorrhage. The incidence of pulmonary complications, especially neurogenic pulmonary edema, is more difficult to establish from available literature. Cardiopulmonary complications have been linked to worsened clinical outcome, suggesting a role for cardiac monitoring and interventions.