Wednesday, July 9, 2014

Cardiac Complications in Subarachnoid Hemorrhage (SAH)

Cardiac complications are not rare in SAH patients. ECG changes can be seen in ¾ of the patients; the varied symptoms include sinus brady-/ tachycardia, QT prolongation, heart blocks, ST elevation and depression, T-wave changes, and pathological Q waves.

Cardiac markers can also be raised. Echocardiogram often show wall dysfunction and histopathological changes in the myocardium. These signs can mimic acute MI. Acute heart failure can lead to arterial hypotension, pulmonary edema, cardiac arrest, and sudden cardiac death. However, coronary angiography shows typically no evidence of coronary artery stenosis. Causes of the cardiac signs are excessive releases of epinephrine and norepinephrine, as well as imbalances in the parasympathetic nervous system.

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