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01-02-2009 | Practical Pearl

Cardiogenic Shock with Stunned Myocardium during Triple-H Therapy Treated with Intra-aortic Balloon Pump Counterpulsation

Authors: Fabio Silvio Taccone, Boris Lubicz, Michael Piagnerelli, Marc Van Nuffelen, Jean-Louis Vincent, Daniel De Backer

Published in: Neurocritical Care | Issue 1/2009

Abstract

Introduction

Excessive use of adrenergic agents may result in stunned myocardium.

Cases

We report the cases of two patients with subarachnoid hemorrhage (SAH) complicated by cardiogenic shock secondary to triple-H therapy for cerebral vasospasm. Both patients had normal cardiac function on admission and no signs of acute myocardial infarction at the onset of cardiogenic shock. Intra-aortic balloon pump (IABP) counterpulsation was used to maintain adequate cerebral perfusion while enabling the high doses of norepinephrine that were being administered to be reduced. Reversal of the myocardial dysfunction after vasopressors were discontinued supported a diagnosis of catecholamine-induced stunned myocardium.

Conclusion

IABP counterpulsation may be one therapeutic option for patients with vasospasm after SAH when high doses of vasopressors can induce severe myocardial dysfunction. However, this invasive device may not be sufficient to maintain adequate cerebral perfusion and fatal embolic events can complicate the clinical course.

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Title: Cardiogenic Shock with Stunned Myocardium during Triple-H Therapy Treated with Intra-aortic Balloon Pump Counterpulsation
Authors: Fabio Silvio Taccone
Boris Lubicz
Michael Piagnerelli
Marc Van Nuffelen
Jean-Louis Vincent
Daniel De Backer
Publication date: 01-02-2009
Publisher: Humana Press Inc
Published in: Neurocritical Care / Issue 1/2009
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-008-9135-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cardiogenic Shock with Stunned Myocardium during Triple-H Therapy Treated with Intra-aortic Balloon Pump Counterpulsation

Abstract

Introduction

Cases

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Cases

Conclusion

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