Takotsubo kardiomiopatija kao posledica aneurizmatskog  subarahnoidalnog krvarenja

Branko Milaković; Tijana Nastasović; Milan Lepić; Nenad Novaković; Siniša Matić; Lukas Rasulić; Andrija  Savić

doi:10.2298/VSP170705179M

Branko Milaković University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Center for Anaesthesiology and Reanimatology, Belgrade, Serbia
Tijana Nastasović Clinical Center of Serbia, Center for Anaesthesiology and Reanimatology, Belgrade, Serbia
Milan Lepić Military Medical Academy, Clinic for Neurosurgery, Belgrade, Serbia
Nenad Novaković Military Medical Academy, Clinic for Neurosurgery, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Siniša Matić Clinical Center of Serbia, Clinic for Neurosurgery, Belgrade, Serbi
Lukas Rasulić University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Clinic for Neurosurgery, Belgrade, Serbia
Andrija Savić Clinical Center of Serbia, Clinic for Neurosurgery, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170705179M

Keywords: coronary angiography, diagnosis, echocardiography, pulmonary edema, subarachnoid hemorrhage, takotsubo cardiomiopathy, ventricular function, left

Abstract

Abstract

Introduction. Subarachnoid haemorrhage (SAH) can be followed by cardiac abnormalities. We describe a patient with Takotsubo cardiomyopathy and neurogenic pulmonary edema (NPE) after aneurysmal SAH. Case report. A previously healthy, postmenopausal woman, suffered from aneurysmal SAH with consequent hydrocephalus. After external ventricular drainage, craniotomy and clipping of the posterior inferior cerebellar artery aneurysm, the patient developed acute heart failure and NPE. Transthoracic echocardiogram showed the left ventricular apical ballooning and hypercontractile basal segments. On chest radiography, bilateral pulmonary infiltrates were seen. Seventeen days after the SAH attack, the patient was discharged from hospital. Postponed coronary angiography revealed no signs of coronary artery disease. Conclusion. This case and review of the relevant literature suggest that Takotsubo cardiomyopathy and neurogenic pulmonary edema are not uncommon after aneurysmal SAH.

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