Cardiac Implications of Neurological Disease

Abstract

For a long time, empirical observation and popular wisdom have suggested a tight link between neurological disease and cardiac complications, yet only in recent years has the improvement of knowledge supported by new technical approaches allowed a more detailed insight in the mechanisms underlying such connection. Both acute and chronic brain diseases may have relevant impacts on heart eliciting arrhythmias as well as myocardial ischemia, which might have catastrophic consequences. In this chapter, we will illustrate the most frequent acute and chronic neurological diseases in which clinical relevant cardiac complications manifest. In the first section, the physiological basis of the complex and intriguing relationship between heart and brain under physiological conditions will be discussed. Thereafter, we will focus on cerebrovascular accidents, along with traumatic brain and spinal cord injury, epilepsy, immune-mediated polyradiculoneuropathies, and myasthenia gravis, which represent the most frequent categories for acute neurocardiac complications. In the second part of this chapter, recent additions to our knowledge on dysautonomia and myocardial denervation observed in neurological degenerative disease will be illustrated. A better understanding of the intimate connections between brain and heart is the basis for a more affective prevention of cardiac complications in patients with neurological disease and customized therapeutical interventions of neurological diseases.