Ampulla cardiomyopathy associated with aneurysmal subarachnoid hemorrhage: report of 6 patients

Abstract

Background The authors report 6 cases of aneurysmal SAH associated with ampulla cardiomyopathy, which has been considered a unique type of stunned myocaridum. Case Description All patients were female, ranged from 35 to 79 years, and their echocardiograms revealed typical cardiac wall motions: the hypokinesia in the apical area of the left ventricle associated with the hyperkinesia in the basal area. In all, the cardiac function started to recover in the first few days; however, associated pulmonary congestions delayed aneurysmal surgeries in 3 patients. Among 3 patients whose surgeries were delayed, one died due to rerupture of aneurysm and another due to severe pneumonia. The other 4 patients recovered well, although one had left ventricular mural thrombus, which was treated successively with anticoagulant. Conclusions It is considered highly important for neurosurgeons to be familiar with this clinical entity, since this transient cardiac function disturbance can be diagnosed at the initial presentation with a unique wall motion. The significance and clinical features of ampulla cardiomyopathy are discussed.