Academic Journal

Diagnosis and Management of Takotsubo Syndrome in Acute Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Review

التفاصيل البيبلوغرافية
العنوان: Diagnosis and Management of Takotsubo Syndrome in Acute Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Review
المؤلفون: Dorottya Szántó, Péter Luterán, Judit Gál, Endre V. Nagy, Béla Fülesdi, Csilla Molnár
المصدر: Reviews in Cardiovascular Medicine, Vol 24, Iss 6, p 177 (2023)
بيانات النشر: IMR Press, 2023.
سنة النشر: 2023
المجموعة: LCC:Diseases of the circulatory (Cardiovascular) system
مصطلحات موضوعية: takotsubo syndrome, subarachnoid hemorrhage, neurogenic stunned myocardium, delayed cerebral ischemia, intracranial aneurysm treatment, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: Takotsubo syndrome (TS) is a frequent complication of subarachnoid hemorrhage (SAH), especially in massive SAH with severe neurological damage. The initial presentation of TS is similar to acute coronary syndrome, causing differential diagnostic issues. Unnecessary diagnostic steps and uncertainty in therapy may delay the definitive treatment of the aneurysm, therefore increasing the risk of rebleeding. The purpose of this review is to summarize the latest knowledge on the diagnosis and therapy of TS in SAH and to provide a diagnostic and therapeutic algorithm for the acute phase, promoting the early definitive treatment of the aneurysm. Rapid hemodynamic stabilization and early aneurysm securing are key points in reducing the risk of delayed cerebral ischemia and improving outcomes. In acute SAH noninvasive bedside diagnostic methods are preferred and securing the aneurysm is the priority. The combination of electrocardiography, cardiac biomarkers, and echocardiography is of great importance in differentiating TS from acute myocardial infarction. The risk-benefit ratio of coronary angiography should be carefully and individually considered and its use should be limited to patients with strong evidence of myocardial ischemia, after the successful endovascular treatment of the aneurysm. Invasive hemodynamic monitoring may be beneficial in cases of cardiogenic shock or pulmonary edema. In patients with hemodynamical instability secondary to TS, the use of non-catecholamine inotropes, especially levosimendan is recommended. In refractory hypotension, mechanical support should be considered. The left ventricular function improves within days to months after the acute event, low initial ejection fraction may predispose to delayed recovery.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1530-6550
Relation: https://www.imrpress.com/journal/RCM/24/6/10.31083/j.rcm2406177; https://doaj.org/toc/1530-6550
DOI: 10.31083/j.rcm2406177
URL الوصول: https://doaj.org/article/fdda14be3ae74100bff3657434a8461f
رقم الانضمام: edsdoj.fdda14be3ae74100bff3657434a8461f
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:15306550
DOI:10.31083/j.rcm2406177