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. 2023 Apr 14;85(5):2186-2189.
doi: 10.1097/MS9.0000000000000636. eCollection 2023 May.

Acute neurogenic stunned myocardium in a patient with Guillain-Barré syndrome: case report

Choukri Bahouh  1   2 , Inass Arhoun El Haddad  1   2 , Amine Elmouhib  1   2 , Ilyass Laaribi  1   2 , Hanane El Adak  3 , Oumaima Hattab  1   4 , Nouha El Ouafi  2   4   5 , Houssam Bkiyar  1   2   5 , Brahim Housni  1   2   5
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Acute neurogenic stunned myocardium in a patient with Guillain-Barré syndrome: case report

Choukri Bahouh et al. Ann Med Surg (Lond). .

Abstract

Autonomic dysfunction is a prevalent symptom of Guillain-Barré syndrome (GBS); cardiovascular involvement in this scenario has been mentioned infrequently in the literature.

Case presentation: A 65-year-old man with GBS presented with reversible left ventricular systolic failure. On first presentation, our patient had no history or indications of heart malfunction. During the clinical manifestation of his autonomic dysfunction, he had electrocardiographic alterations, modestly increased cardiac enzymes, significant left ventricular systolic dysfunction, and segmental wall motion irregularity. Once the initial episode was over, these anomalies and his symptoms resolved quickly.

Discussion: We believe the reversible left ventricular dysfunction was caused by the toxic impact of elevated catecholamines as well as transiently injured sympathetic nerve endings in the myocardium, which was apparently caused by GBS. We recommend that echocardiography be performed in patients who exhibit clinical signs of autonomic dysfunction, particularly if they are associated with abnormal electrocardiographic findings, cardiac enzyme elevation, or hemodynamic instability, so that appropriate medical therapy can be instituted as soon as possible.

Conclusion: GBS is a not a very rare situation in our context. Thus, doctors are supposed to know the life-threatening complications such as neurogenic stunned myocardium and be prepared to dodge it.

Keywords: Guillain–Barré syndrome; coronarography; electrocardiography; neurogenic stunned myocardium.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The patient’s normal electrocardiogram at admission. aVF, augmented vector foot, aVL, augmented vector left; aVR, augmented vector right.
Figure 2
Figure 2
The patient’s electrocardiogram after the state of shock where he presented an elevated ST segment in the anterior. aVF, augmented vector foot, aVL, augmented vector left; aVR, augmented vector right.
Figure 3
Figure 3
Angiographically normal coronary systems: 1: right; 2: left.
See this image and copyright information in PMC

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