The Use of Levosimendan in the Treatment of Neurogenic Stress Cardiomyopathy in a Patient with Nontraumatic Subarachnoid Hemorrhage (Case Report)

We present a case of cardiogenic shock due to neurogenic stress cardiomyopathy (NSC) in a patient with nontraumatic subarachnoid hemorrhage caused by a ruptured aneurysm of the right pericallosal artery. Due to the catecholamine-resistant shock, levosimendan was administered under advanced hemodynamic control, including transpulmonary thermodilution and echocardiography. This resulted in an improved cardiac contractility and reduced demand for catecholamines. Full stabilization of hemodynamic parameters was achieved by day 5. In the discussion section we reviewed available published case reports of using levosimendan in stress cardiomyopathy treatment.

Perfect storm along the neuro-cardiac axis: stroke complicated by acute biventricular dysfunction—Takotsubo syndrome or neurogenic stress cardiomyopathy?

Acute biventricular dysfunction complicating acute ischaemic stroke poses diagnostic and therapeutic challenges with respect to anticoagulation and short-term and long-term prognosis. We present the uncommon case of an elderly patient presenting with this clinical scenario, who made a full recovery on conservative therapy. Management strategies are discussed and the emerging topic of neuro-cardiac syndromes, namely neurogenic stress cardiomyopathy as distinct from Takotsubo syndrome, is explored.