Neurogenic Stunned Myocardium in Severe Neurological Injury. [Review] - 2019

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.


English

1528-4042

10.1007/s11910-019-0999-7 [doi] 10.1007/s11910-019-0999-7 [pii]


*Donor Selection/mt [Methods]
*Myocardial Stunning
Acute Coronary Syndrome/di [Diagnosis]
Diagnosis, Differential
Humans
Myocardial Stunning/di [Diagnosis]
Myocardial Stunning/ep [Epidemiology]
Myocardial Stunning/pp [Physiopathology]
Myocardial Stunning/th [Therapy]


MedStar Heart & Vascular Institute
MedStar Washington Hospital Center


Neurosurgery
Surgery/Surgical Critical Care


Journal Article
Review