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Case Reports
. 2005 Apr;100(4):1147-1149.
doi: 10.1213/01.ANE.0000147704.90285.2A.

Delayed cardiogenic shock and acute lung injury after aneurysmal subarachnoid hemorrhage

Ives de Chazal  1 , William M Parham 3rd, Panayota Liopyris, Eelco F M Wijdicks
Affiliations
Case Reports

Delayed cardiogenic shock and acute lung injury after aneurysmal subarachnoid hemorrhage

Ives de Chazal et al. Anesth Analg. 2005 Apr.

Abstract

Both cardiac and lung injury after aneurysmal subarachnoid hemorrhage has been attributed to an adrenergic surge. Cardiogenic shock is very uncommon. We describe a 55-yr-old woman with a delayed cardiogenic shock emerging within hours after aneurysmal rupture. Cardiac damage was documented by increased serum troponin T, CPK-mb fraction, and severe wall motion abnormality, which included an akinetic apex on echocardiography (ejection fraction of 33%). Her coronary angiogram was normal. Decreased cardiac index, increased systemic and pulmonary vascular resistance indices, and persistent oxygen desaturation despite improving ventricular contractility documented both cardiac and pulmonary injury. After treatment with dobutamine and milrinone all manifestations resolved.

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