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2020 Aug 22

Pol Merkur Lekarski



Takotsubo syndrome after nimodipine-induced hypotension treated with norepinephrine in a female with subarachnoid hemorrhage.


Elikowski W, Małek-Elikowska M, Piestrzeniewicz R, Fertała N, Zawodna M, Ganowicz-Kaatz T, Baszko A, Smól S
Pol Merkur Lekarski. 2020 Aug 22; 49(286):236-240.
PMID: 32827417.


The prevalence of takotsubo syndrome (TTS) in patients with subarachnoid hemorrhage (SAH) is much higher than in the general population. Clinical and experimental observations confirm secondary to brain damage catecholamine-mediated cardiac injury resulting in reversible left ventricular (LV) dysfunction. However, other triggers can also be involved in TTS development e.g. manipulations during surgical or endovascular treatment of a bleeding intracranial aneurysm, concomitant hyponatremia or infection, intubation, blood transfusion and pharmacologic treatment. Nimodipine is recommended in SAH to prevent cerebral arteries vasospasm but can cause hypotension, so vasopressors, e.g. norepinephrine (NE) are commonly used to reach target blood pressure.