APP Plenary Session: 2019 AANS Annual Scientific Meeting-Cardiovascular Changes in the Setting of SAH

Video Transcription

Video Summary

In this video, Dr. Ben Waldau discusses the cardiovascular effects of subarachnoid hemorrhage. He explains that subarachnoid hemorrhage can cause neurogenic stunning of the heart, which is a reversible reduction of heart function without tissue damage or reduced blood flow. This stunning is likely caused by norepinephrine release from the hypothalamus in response to the brain bleed. Dr. Waldau discusses various basic science models that explain the mechanism of neurogenic stunning, including oxidative stress, calcium overload, and dysfunction of ATPases. He also shares clinical vignettes of patients with subarachnoid hemorrhage and describes how they were managed. Treatment options discussed include vasopressors, inotropes, and, in severe cases, an intra-aortic balloon pump. Dr. Waldau emphasizes the importance of aggressive management and explains that the condition is reversible, unlike primary cardiac causes of heart failure. He concludes by stating that while stunned myocardium is associated with poor outcomes and increased risk of vasospasm, good outcomes can be achieved with aggressive treatment.

Asset Caption

Cardiovascular Changes in the Setting of SAH

Keywords

subarachnoid hemorrhage

neurogenic stunning

norepinephrine release

oxidative stress

calcium overload

aggressive management

good outcomes