Cardiac Dysfunction in Neurocritical Care: An Autonomic Perspective
| Autor: | Bennson Samuel, Mohammad Ibrahim, Kushak Suchdev, Wazim Mohamed |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Neurology Critical Care Critical Care and Intensive Care Medicine Sudden death 03 medical and health sciences 0302 clinical medicine Neuroimaging Humans Medicine Intensive care medicine business.industry Mechanism (biology) Perspective (graphical) Neurointensive care Arrhythmias Cardiac 030208 emergency & critical care medicine Neurocardiology Heart Arrest Autonomic nervous system Death Sudden Cardiac Autonomic Nervous System Diseases Neurology (clinical) Cardiomyopathies business 030217 neurology & neurosurgery |
| Zdroj: | Neurocritical Care. 30:508-521 |
| ISSN: | 1556-0961 1541-6933 |
| DOI: | 10.1007/s12028-018-0636-3 |
| Popis: | A number of neurologic disorders can cause cardiac dysfunction by involving the conductive system and contractile apparatus of the heart. This is especially prominent in the neurocritical care setting where the spectrum of cardiac dysfunction due to acute neurologic injury ranges from trivial and isolated electrocardiographic changes to malignant arrhythmias and sudden death (Table 1). The mechanism of these cardiac complications is complex and not fully understood. An understanding of the neuroanatomical structures and pathways is of immense importance to comprehend the underlying pathophysiology that culminates as cardiac damage and dysregulation. Once the process is initiated, it can complicate and adversely affect the outcome of primary neurologic conditions commonly seen in the neurocritical care setting. Not only are these cardiac disorders under-recognized, there is a paucity of data to formulate evidence-based guidelines regarding early detection, acute management, and preventive strategies. However, certain details of clinical features and their course combined with location of primary neurologic lesion on neuroimaging and data obtained from laboratory investigations can be of great value to develop a strategy to appropriately manage these patients and to prevent adverse outcome from these cardiac complications. In this review, we highlight the mechanisms of cardiac dysfunction due to catastrophic neurologic conditions or due to stress of critical illness. We also address various clinical syndromes of cardiac dysfunction that occur as a result of the neurologic illness and in turn may complicate the course of the primary neurologic condition. |
| Databáze: | OpenAIRE |
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