The Brain–Heart Crosstalk

Acute neurocardiogenic injury is a relevant complication occurring after an acute brain injury, especially after subarachnoid haemorrhage, and is associated with an increased risk of morbidity and mortality. The cardiac involvement can be expressed as ECG anomalies (QT interval prolongation, T wave and ST segment anomalies, cardiac arrhythmias), elevation of the serum markers of cardiac injury or regional or global wall motion abnormalities resulting in different grades of heart failure, from mild dysfunction to cardiogenic shock. This cardiac dysfunction, also known as neurogenic stress cardiomyopathy, is usually reversible and functional in origin but is associated with increased morbidity and mortality. In clinical practice, acute neurocardiogenic injury is generally underdiagnosed. This chapter discusses relevant pathophysiological changes occurring at cardiac level after an acute brain injury and the clinical implications of brain–heart crosstalk.