scholarly journals Persistent left ventricular systolic dysfunction for atleast 1 year with the onset of takotsubo cardiomyopathy 7 days after subarachnoid hemorrhage surgery: a case report

Nosotchu ◽  
2017 ◽  
Vol 39 (2) ◽  
pp. 150-155
Author(s):  
Takeshi Uemura ◽  
Ikuo Ihara ◽  
Atsushi Fukuma ◽  
Syozou Kawai ◽  
Keiji Sugimoto ◽  
...  
Keyword(s):  
Case Report ◽  
Subarachnoid Hemorrhage ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Systolic Dysfunction

scholarly journals Combined neurogenic pulmonary edema and atypical takotsubo cardiomyopathy in a patient with ischaemic stroke: a unique case report

2021 ◽  
Author(s):  
Letizia Riva ◽  
Gianni Casella ◽  
Luigi Simonetti ◽  
Andrea Zini
Keyword(s):  
Ischaemic Stroke ◽  
Takotsubo Cardiomyopathy ◽  
Neurological Disorders ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Invasive Mechanical Ventilation ◽  
Left Ventricular ◽  
Neurogenic Pulmonary Edema ◽  
Ventricular Systolic Dysfunction ◽  
Nervous Stimulation

Abstract Background Neurogenic pulmonary oedema (NPE) and Takotsubo cardiomyopathy are rare complications of ischaemic stroke. They are considered to be due to an excess catecholamine release after sympathetic nervous stimulation following stroke onset. Among the different types of Takotsubo cardiomyopathy, apical ballooning is recognized as the typical form, but 3 atypical patterns have been described (midventricular, basal and focal) which are more commonly observed in patients with neurological disorders. Case summary A 78-year-old woman was treated with intravenous alteplase and underwent mechanical thrombectomy for ischaemic stroke. During the procedure, her respiratory condition quickly worsened requiring invasive mechanical ventilation because of a wide and persistent reduction of the inspiratory oxygen fraction/arterial partial oxygen pressure ratio (FiO2/PaO2). Transthoracic echocardiography revealed moderate left ventricular systolic dysfunction with akinesis of the septal-apical and inferior-apical segments. Coronary angiography excluded obstructive lesions and/or evidence of acute plaque rupture. Ventriculography confirmed akinesis/dyskinesis of the inferior segment of the left ventricular apex associated with normal kinesis of the remaining segments. Chest X-ray revealed an infiltrative shadow on both lungs. After 24 hours from NPE onset, her respiratory function improved and she was finally discharged on day 7 without neurological defects. Left ventricular systolic dysfunction was reversible and ejection fraction normalized in 3 months. Discussion It is a very rare case of simultaneous NPE and Takotsubo cardiomyopathy following ischaemic stroke. Moreover, it is unique in that it is the first observation of NPE associated with an atypical pattern of Takotsubo cardiomyopathy, which is more frequent in patients with neurological disorders. A rapid recognition and treatment are essential for patient survival.

Prospective analysis of prevalence, distribution, and rate of recovery of left ventricular systolic dysfunction in patients with subarachnoid hemorrhage

2006 ◽  
Vol 105 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Nader Banki ◽  
Alexander Kopelnik ◽  
Poyee Tung ◽  
Michael T. Lawton ◽  
Daryl Gress ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Recovery Rate ◽  
Time Course ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Cardiac Injury ◽  
Left Ventricular ◽  
Lv Function ◽  
Ventricular Systolic Dysfunction ◽  
Lv Dysfunction

Object Subarachnoid hemorrhage (SAH) has been associated with cardiac injury and left ventricular (LV) dysfunction. The incidence and natural history of neurocardiogenic injury after SAH remains poorly understood. The objective of this study was to describe the incidence, time course, recovery rate, and segmental patterns of LV dysfunction after SAH. Methods Echocardiography was performed three times over a 7-day period in 173 patients with SAH. The incidence of global (ejection fraction [EF] < 50%) and segmental (any regional wall-motion abnormality [RWMA]) LV dysfunction was measured. The time course of LV dysfunction was determined by comparing the prevalence of LVEF less than 50% and RWMA at 0 to 2, 3 to 5, and 6 to 8 days after SAH. The recovery rate was defined as the proportion of patients with partial or complete normalization of function. The distribution of RWMAs among 16 LV segments was also determined. An LVEF less than 50% was found in 15% of patients, and 13% had an RWMA with a normal LVEF. There was a trend toward increased dysfunction at 0 to 2 days after SAH, compared with 3 to 8 days after SAH. Recovery of LV function was observed in 66% of patients. The most frequently abnormal LV segments were the basal and middle ventricular portions of the anteroseptal and anterior walls. The apex was rarely affected. Conclusions Left ventricular systolic dysfunction occurs frequently after SAH and usually improves over time. The observed segmental patterns of LV dysfunction often do not correlate with coronary artery distributions.

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