Subarachnoidal haemorrhage related cardiomyopathy: an overview of Tako-Tsubo cardiomyopathy and related cardiac syndromes

Abstract

Introduction Subarachnoid haemorrhage (SAH) is caused by a ruptured intracranial aneurysm leading to acute extravasation of blood into the subarachnoid space. SAH has an incidence of 6.3 per 100000 persons per year in Europe and accounts for 5% of all strokes. SAH occurs at relatively young age and has poor clinical outcomes and high mortality rates. Cardiac syndromes are regularly seen in patients with acute neurologic disease including SAH. These cardiac complications of SAH are associated with increased morbidity and mortality, and present in a large variety and severity. Areas covered The main goal of this review is to describe the subarachnoid haemorrhage related cardiac syndromes. Secondly, we will provide an overview of the underlying pathophysiology regarding the development of cardiac syndromes. Thirdly, we will describe the impact of cardiac syndromes on patient outcome. Expert opinion Of all neurology patients SAH patients have the highest risk of developing Takotsubo syndrome (TTS) in SAH patients occurs in about 0.8% to 30% of patients. Both TTS and Neurogenic stunned myocardium (NSM) have many similarities on echocardiographic evaluation. In European Cardiology consensus SAH is recognized as primary cause of TTS.