BrainWaves: A Neurology Podcast

#13 The broken heart syndrome

BrainWaves: A Neurology Podcast

When the heart stops working, the brain stops working. But if the brain stops working, does the heart shut down? In this episode, Dr. David Manly (Duke Cardiology) discusses the pathogenesis and management of the reversible syndromes of neurogenic stress cardiomyopathy. In full disclosure, this is a re-mastered re-run of a prior episode posted June 29, 2016. With some updates at the end.

Produced by James E. Siegler. Music by Lee Rosevere. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making.

REFERENCES

1. Bybee KA, Prasad A. Stress-related cardiomyopathy syndromes. Circulation. 2008;118:397-409

2. Lyon AR, Rees PS, Prasad S, Poole-Wilson PA, Harding SE. Stress (takotsubo) cardiomyopathy--a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med. 2008;5:22-29

3. Paur H, Wright PT, Sikkel MB, Tranter MH, Mansfield C, O'Gara P, et al. High levels of circulating epinephrine trigger apical cardiodepression in a beta2-adrenergic receptor/gi-dependent manner: A new model of takotsubo cardiomyopathy. Circulation. 2012;126:697-706

4. Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P, Carbone I, Muellerleile K, Aldrovandi A, et al. Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy. JAMA : the journal of the American Medical Association. 2011;306:277-286

5. Banki NM, Kopelnik A, Dae MW, Miss J, Tung P, Lawton MT, et al. Acute neurocardiogenic injury after subarachnoid hemorrhage. Circulation. 2005;112:3314-3319

6. Yoshimura S, Toyoda K, Ohara T, Nagasawa H, Ohtani N, Kuwashiro T, et al. Takotsubo cardiomyopathy in acute ischemic stroke. Annals of neurology. 2008;64:547-554

7. Grabowski A, Kilian J, Strank C, Cieslinski G, Meyding-Lamade U. Takotsubo cardiomyopathy--a rare cause of cardioembolic stroke. Cerebrovascular diseases. 2007;24:146-148

8. Finsterer J, Wahbi K. Cns-disease affecting the heart: Brain-heart disorders. Journal of the neurological sciences. 2014;345:8-14

9. Stiermaier T, Moeller C, Oehler K, Desch S, Graf T, Eitel C, Vonthein R, Schuler G, Thiele H and Eitel I. Long-term excess mortality in takotsubo cardiomyopathy: predictors, causes and clinical consequences. European journal of heart failure. 2016;18:650-6.

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