CNS Guest Blog: Understanding Neurogenic Stunned Myocardium

Motor vehicle accident complicated by neurogenic stunned myocardium and neurogenic shock

Acute brain injury and high spinal cord injury can trigger powerful autonomic responses that transiently impair cardiac function—a phenomenon known as neurogenic stunned myocardium that deserves greater clinical awareness.

We welcome this guest blog from Pacific Medical Training:

Abstract

A 25-year-old woman was a restrained driver in a rollover motor vehicle accident (MVA) and suffered a C5-C6 fracture-dislocation with spinal cord injury. She developed neurogenic stunned myocardium and neurogenic shock. Her unopposed parasympathetic nervous system triggered multiple episodes of unstable bradycardia which resulted in multiple cardiac arrests. She was treated with inotropes and vasopressors to keep her mean arterial pressure (MAP) > 85 mmHg for adequate spinal perfusion. Chronotropic medications were used to elevate her heart rate (HR) in order to prevent her unstable bradyarrhythmia from causing a cardiac arrest.

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