Benjamin B Kenigsberg1,2, Christopher F Barnett1,2, Jeffrey C Mai3, Jason J Chang4,5. 1. Department of Critical Care Medicine, MedStar Washington Hospital Center, 110 Irving St, NW, Rm 4B42, Washington, DC, 20010, USA. 2. Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. 3. Department of Neurosurgery, Georgetown University and MedStar Washington Hospital Center, Washington, DC, USA. 4. Department of Critical Care Medicine, MedStar Washington Hospital Center, 110 Irving St, NW, Rm 4B42, Washington, DC, 20010, USA. jjwchang@hotmail.com. 5. Department of Neurology, Georgetown University School of Medicine, Washington, DC, USA. jjwchang@hotmail.com.
Abstract
PURPOSE OF REVIEW: Neurogenic stunned myocardium (NSM) is a poorly recognized cardiac manifestation of neurological illness. This review addresses the contemporary understanding of NSM pathophysiology, epidemiology, diagnosis, and clinical management. RECENT FINDINGS: While the precise pathophysiology and diagnosis remain unclear, NSM is phenotypically atypical stress cardiomyopathy that can be partially attributed to excess catecholaminergic toxicity. NSM is a diagnosis of exclusion where electrocardiography, echocardiography, and cardiac biomarkers are frequently abnormal. Clinical expertise is crucial to evaluate and differentiate NSM from acute coronary syndrome and in the evaluation of potential cardiac transplantation donors after unsalvageable severe neurological injury. Neurogenic stunned myocardium is a relatively common and clinically impactful condition. More research is needed, particularly to refine clinical prognostication of NSM and rule out intrinsic cardiac injury in order to optimize donor candidacy in the event of brain death.
PURPOSE OF REVIEW: Neurogenic stunned myocardium (NSM) is a poorly recognized cardiac manifestation of neurological illness. This review addresses the contemporary understanding of NSM pathophysiology, epidemiology, diagnosis, and clinical management. RECENT FINDINGS: While the precise pathophysiology and diagnosis remain unclear, NSM is phenotypically atypical stress cardiomyopathy that can be partially attributed to excess catecholaminergic toxicity. NSM is a diagnosis of exclusion where electrocardiography, echocardiography, and cardiac biomarkers are frequently abnormal. Clinical expertise is crucial to evaluate and differentiate NSM from acute coronary syndrome and in the evaluation of potential cardiac transplantation donors after unsalvageable severe neurological injury. Neurogenic stunned myocardium is a relatively common and clinically impactful condition. More research is needed, particularly to refine clinical prognostication of NSM and rule out intrinsic cardiac injury in order to optimize donor candidacy in the event of brain death.
Authors: Santosh B Murthy; Shreyansh Shah; Chethan P Venkatasubba Rao; Jose I Suarez; Eric M Bershad Journal: J Clin Neurosci Date: 2014-02-06 Impact factor: 1.961
Authors: Adrian Quinto; Maja Ramin-Wright; Sabina Hunziker; Christoph Becker; Katharina Beck; Alessia Vincent; Kai Tisljar; Giulio Disanto; Pascal Benkert; David Leppert; Hans Pargger; Stephan Marsch; Nils Peters; Jens Kuhle Journal: Crit Care Date: 2021-01-20 Impact factor: 9.097