[Acute diseases of the brain and heart : A reciprocal culprit-victim relationship].

The reciprocal culprit-victim relationship between the brain and the heart leads to dysfunction and damage to the other organ, especially in acute and severe diseases of one of both organs. In addition, both organ systems can be affected by identical systemic processes, e. g., arteriosclerotic changes. Cardiac embolic formation and pumping failure lead to focal cerebral ischemia or global hypoxia. Cerebral diseases leading to cardiac changes are acute cerebrovascular attacks such as cerebral infarction, intracerebral hemorrhage and subarachnoid hemorrhage, as well as epileptic seizures. The pathophysiological mechanisms of changes of the brain-heart axis include cerebrally induced autonomic dysregulation, neuroendocrine regulatory disorders, and systemic inflammatory processes. The effects on the heart are evident in up to 75% of patients with acute brain diseases leading to ECG changes, arrhythmias, increase in cardiac enzymes and myocardial damage even to sudden cardiac death. For this reason, cardiac monitoring should be provided in severe acute brain diseases.