Neurogenic Stunned Myocardium: A Review

AACN Adv Crit Care. 2021 Sep 15;32(3):275-282. doi: 10.4037/aacnacc22021250.

Abstract

Neurogenic stunned myocardium is a form of stress cardiomyopathy. The disorder is sometimes referred to as atypical Takotsubo cardiomyopathy. The pathophysiology of neurogenic stunned myocardium is hypothesized to involve significant overdrive of the sympathetic nervous system after a brain injury. Treatment options for a patient with a brain injury who has progressed to cardiogenic shock remain controversial, with no consistent guidelines. A patient with subarachnoid hemorrhage who progresses to cardiogenic shock with concurrent cerebral vasospasm presents a special treatment challenge. Neurogenic stunned myocardium is reversible; however, it must be recognized immediately to avoid or manage potential complications, such as cardiogenic shock and pulmonary edema. A multifaceted treatment approach is needed for the patient with cardiogenic shock and concurrent vasospasm.

Keywords: Takotsubo cardiomyopathy; cardiogenic shock; cerebral vasospasm; neurogenic stunned myocardium; subarachnoid hemorrhage.

Publication types

  • Review

MeSH terms

  • Humans
  • Myocardial Stunning* / diagnosis
  • Pulmonary Edema / diagnosis
  • Pulmonary Edema / etiology
  • Subarachnoid Hemorrhage
  • Takotsubo Cardiomyopathy / complications
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / therapy
  • Vasospasm, Intracranial