Abstract
We present a case of cardiogenic shock due to neurogenic stress cardiomyopathy (NSC) in a patient with nontraumatic subarachnoid hemorrhage caused by a ruptured aneurysm of the right pericallosal artery. Due to the catecholamine-resistant shock, levosimendan was administered under advanced hemodynamic control, including transpulmonary thermodilution and echocardiography. This resulted in an improved cardiac contractility and reduced demand for catecholamines. Full stabilization of hemodynamic parameters was achieved by day 5. In the discussion section we reviewed available published case reports of using levosimendan in stress cardiomyopathy treatment.
Highlights
Neurogenic stress cardiomyopathy (NSC) is a reversible myocardial dysfunction with severe impairment of left ventricular (LV) systolic function developing in acute brain injury, most often due to the non-traumatic subarachnoid hemorrhage (SAH) [1]
The severity of myocardial damage in SAH can vary from asymptomatic changes found on echocardiography and ECG with minimal elevation of cardiac enzymes to severe left ventricular failure, up to pulmonary edema and cardiogenic shock [5]
This paper reports a case of successful use of levosimendan for the treatment of cardiogenic shock in NSC developed in a patient with an acute SAH due to right pericallosal artery aneurysm rupture
Summary
Использование левосимендана при лечении нейрогенной стрессорной кардиомиопатии у пациентки с субарахноидальным кровоизлиянием (клиническое наблюдение). Представили наблюдение кардиогенного шока вследствие нейрогенной стрессовой кардиомиопатии (НСКМП) у пациентки с нетравматическим субарахноидальным кровоизлиянием вследствие разрыва артериальной аневризмы правой перикаллезной артерии. В связи с рефрактерным к катехоламинам течением шока приняли решение об использовании левосимендана под расширенным гемодинамическим контролем, включающим в себя транспульмональную термодилюцию и эхокардиографию. В обсуждении рассмотрели наблюдения лечения стрессовой кардиомиопатии с использованием левосимендана, представленные в литературе.
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