APP Master Sessions-Cardiovascular Changes in the Setting of SAH

Video Transcription

Video Summary

Dr. Ben Waldau, a neurosurgeon at UC Davis, gave a lecture on cardiovascular effects in the setting of subarachnoid hemorrhage. He discussed the concept of neurogenic stun myocardium, which is a reversible reduction in heart function caused by increased norepinephrine release due to hypothalamic injury. Dr. Waldau explained that the increased norepinephrine release leads to adrenergic signaling in the heart, causing a temporary cardiomyopathy. He discussed the use of medications such as dobutamine and milrinone, as well as the intra-aortic balloon pump, for supportive treatment. He also emphasized the importance of aggressive management in these cases, as stunned myocardium can be reversed with proper treatment. Dr. Waldau shared a case study of a patient who had a subarachnoid hemorrhage and developed stunned myocardium. The patient underwent aneurysm clipping and had a good outcome after aggressive management. He explained that stunned myocardium is associated with higher mortality and complications, but with proper treatment, it can have positive outcomes. Dr. Waldau concluded by highlighting the importance of differentiating between neurogenic stun myocardium and other cardiac conditions, as the treatment approaches can vary.

Keywords

neurosurgeon

subarachnoid hemorrhage

neurogenic stun myocardium

norepinephrine release

aggressive management

cardiomyopathy

treatment approaches