Seby John 1 , Rula A Hajj-Ali 2 , David Min 3 , Leonard H Calabrese 2 , Russell Cerejo 4 , Ken Uchino 5 Show Affiliations »
Abstract
BACKGROUND: Systemic vascular alterations have not been described in reversible cerebral vasoconstriction syndrome (RCVS). We present a case series of RCVS patients having cardiac dysfunction during ictus, with a subset showing complete resolution of cardiomyopathy. METHODS: Retrospective case-series: Cardiac left ventricular ejection fraction (LVEF) and wall motion abnormalities (WMA) visualized on transthoracic echocardiography (TTE), performed during RCVS ictus and follow-up was analyzed. RESULTS: Of 68 patients, 18 (26%) had a TTE performed around ictus. Three of 18 (17%) patients demonstrated WMA on initial TTE. All three patients were female without previous coronary artery disease or heart failure, and were asymptomatic from the cardiac dysfunction. WMA resolved completely on follow-up in Patients 1 and 2. Global LV dysfunction persisted for at least 90 days in Patient 3. CONCLUSION: Although the exact pathophysiology of the cardiomyopathy is uncertain, it may be related to localized coronary vasoconstriction causing myocardial ischemia/infarction. Vasoconstriction may not be limited to the cerebral vasculature and may involve extracerebral organs. Cardiac ventricular abnormalities may be a part of the RCVS spectrum. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
BACKGROUND: Systemic vascular alterations have not been described in reversible cerebral vasoconstriction syndrome (RCVS). We present a case series of RCVS patients having cardiac dysfunction during ictus, with a subset showing complete resolution of cardiomyopathy . METHODS: Retrospective case-series: Cardiac left ventricular ejection fraction (LVEF) and wall motion abnormalities (WMA) visualized on transthoracic echocardiography (TTE), performed during RCVS ictus and follow-up was analyzed. RESULTS: Of 68 patients , 18 (26%) had a TTE performed around ictus. Three of 18 (17%) patients demonstrated WMA on initial TTE. All three patients were female without previous coronary artery disease or heart failure , and were asymptomatic from the cardiac dysfunction . WMA resolved completely on follow-up in Patients 1 and 2. Global LV dysfunction persisted for at least 90 days in Patient 3. CONCLUSION: Although the exact pathophysiology of the cardiomyopathy is uncertain, it may be related to localized coronary vasoconstriction causing myocardial ischemia /infarction . Vasoconstriction may not be limited to the cerebral vasculature and may involve extracerebral organs. Cardiac ventricular abnormalities may be a part of the RCVS spectrum. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Entities: Disease
Species
Keywords:
Reversible cerebral vasoconstriction syndrome (RCVS); cardiomyopathy; heart-brain connection; stress-induced cardiomyopathy; transient
Mesh： See more »
Year: 2014
PMID： 25164918 DOI： 10.1177/0333102414547139
Source DB: PubMed Journal: Cephalalgia ISSN： 0333-1024 Impact factor: 6.292