Neurogenic stunned myocardium: an unusual postoperative complication

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Myke DrayerRick Harrison

Abstract

In this report of myocardial dysfunction in a pediatric patient after a neurosurgical procedure, we highlight the need for high clinical suspicion for neurogenic stunned myocardium. Case report. A tertiary pediatric intensive care unit. A 7-yr-old boy with a history of Chiari malformation type 1, undergoing his fourth surgical procedure, who developed signs of myocardial infarction in the immediate postoperative period. Serial echocardiograms, a rest-stress myocardial perfusion study, and coronary angiography were performed. Serial troponins were followed. The troponin level normalized 6 days after the initial event, and he was discharged home on a limited course of lisinopril, propanolol, and aspirin and without signs or symptoms of cardiac dysfunction. Neurogenic stunned myocardium is an uncommon event after neurosurgical procedures in children. Pediatric intensivists need to consider this diagnosis in a patient with signs of myocardial dysfunction in the neurosurgical postoperative period. The management of neurogenic stunned myocardium involves close monitoring and establishing the absence of other causes of myocardial ischemia.

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Citations

Sep 18, 2012·Neuroradiology·Francisco Brevis NuñezChristian Dohna-Schwake
Nov 11, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Mary E VallettaArwa Saidi
Apr 12, 2011·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Gabriella De RosaMarco Piastra
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Oct 12, 2010·Pediatric Neurology·Jainn-Jim LinKuang-Lin Lin
Oct 12, 2010·International Journal of Cardiology·Salvatore PatanèSergio Buonamonte
Apr 26, 2011·Neurological Research·Timothy M George, Nicole H Higginbotham
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May 18, 2016·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Joana Faleiro OliveiraHelena Almeida
Sep 28, 2016·Journal of Cardiovascular Medicine·Alessia UrbinatiAndrew L Clark
Apr 20, 2019·Journal of Neurosurgery. Pediatrics·Gabriel Crevier-SorboRoy W R Dudley
Feb 9, 2012·The Journal of Trauma and Acute Care Surgery·Stalin ViswanathanBhavith Remalayam
Feb 24, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Junji KoyamaAtsufumi Kawamura

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