Critical Care Neurocardiology

Abstract

Cardiac disturbances are quite frequent in a stroke patient be it arrhythmia or LV dysfunction. It is becoming quite common to observe the heart and brain interaction in the ICU. Critical care at its core takes into consideration the human body in its entirety. Hence the clinical management of the brain and heart disorders cannot be isolated. The care of neurologic patient is influenced by cardiac diseases, and likewise neurological consideration is essential in many types of heart diseases. Cardiologists and Neurologists view heart and brain alone respectively and ignore the other. There is a lot of literature with evidence regarding the importance of brain–heart interactions from the 80s onwards. However, many do not view them together for management.These relationships in terms of physiological, clinical and management issues daily are of utmost importance in critical care.So, the questions are, can we consider the term Neurocardiology in critical care on a daily basis?What are the interactions between the brain and the heart and what is the concerned pathophysiology? How does it influence in the management and outcomes of patients?In the setting of Critical care, time and proper decision making is a crucial factor. How hemodynamic & intracranial dynamic monitoring helps to determine the immediate and long-term management of the patient and how it influences the outcome will be discussed. We present here a series of two cases which clearly depicted the alterations in the neuro-cardiac axis to reiterate the importance of neurocardiology once again in the critical care setting.