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Acta Medica Medianae
Correspondence to:
18000 Niš, ul. Narodnih heroja br.91 Tel.: 018/532-157 E-mail:beta.jo@sbb.co.yu
Copyright 2008 by Faculty of Medicine, University of Nis |
Original article
DIAGNOSIS AND THERAPY IN TRANSITORY MYOCARDIAL ISCHEMIA IN SPONTANEOUS SUBARACHNOID HEMORRHAGE Anica Pavlovic
Cardiac dysfunction occuring within subarachnoid hemorrhage named neurogenic stunned myocardium have great impact on intensive care of patients with SAH. Timely diagnosis and treatment of such condition can provide better haemodynamics of damaged brain. The standard folow-up was performed in 30 patients vith SAH during two years at the Clinic of Neurosurgery (2005,2006). Serial electrocardiography, echocardiography, as well as laboratory findings of special biomarkers of left ventricular wall motion abnormalities were performed. All patients were treated with Urapidil, Metoprolol, MgSO4 by cheme and ACE inhibitors. Ninety EKG were analyzed in the study, as well as 16 echocardiographies. The highest levels of CPK, CK-MB and TnI before and after the therapy were also recoded. EKG showed the signs of ishemia in 9 of 30 patients on 1st day and 7 of 30 patients on 3rd day of the therapy. The highest level of CK-MB was present during the 1st day with mean value of 67,80±1,83 IU/L that decreased on 3rd day of therapy with mean value of 66,8±1,83 IU/L, TnI was positive in 16 cases. It showed statisticaly significant decrease from 0,29 ng/ml till 0,187 ng/ml and p < 0,01. Myocardial ishaemia has been proven to be a very significant complication in SAH. Appropriate treatment of myocardial ischemia seems to improve systemic haemodynamics, as well as haemodynamics of the damaged brain. Acta Medica Medianae 2008;47(1):19-21.
Key words: myocardial ishaemia, treatmant, spontaneous SAH Fulll text |