医学
心源性休克
蛛网膜下腔出血
心脏病学
心肌病
血管痉挛
病理生理学
肺水肿
内科学
休克(循环)
心肌顿抑
麻醉
心力衰竭
重症监护医学
缺血
心肌梗塞
肺
作者
Amy Stoddard,Donna Lynch-Smith
标识
DOI:10.4037/aacnacc22021250
摘要
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.
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