DIAGNOSIS AND THERAPY IN TRANSITORY MYOCARDIAL ISCHEMIA.docVIP

Original article DIAGNOSIS AND THERAPY IN TRANSITORY MYOCARDIAL ISCHEMIA IN SPONTANEOUS SUBARACHNOID HEMORRHAGE Anica Pavlovic Cardiac dysfunction occurring within subarachnoid hemorrhage named neurogenic stunned myocardium have great impact on intensive care of patients with subarachnoid hemorrhage (SAH). Timely diagnosis and treatment of such condition can provide better haemodynamics of damaged brain. The standard follow-up was performed in 30 patients with SAH during two years at the Clinic of Neurosurgery (2005, 2006). Serial electrocardiography, echocardiography, as well as laboratory findings of special biomarkers of left ventricular wall motion abnormalities were performed. All patients were treated with Urapidil, Metoprolol, MgSO by scheme and ACE inhibitors. Ninety 4 EKG were analyzed in the study, as well as 16 echocardiographies. The highest levels of CPK, CK-MB and TnI before and after the therapy were also recoded. EKGs showed the signs of ischemia in 9 of 30 patients at day 1 and 7 of 30 patients at day 3 of the therapy. The highest level of CK-MB was present during the 1st day with mean value of 67,80±1,83 IU/l that decreased at day 3 of the therapy with mean value of 66,8±1,83 IU/l, TnI was positive in 16 cases. It showed statistically significant decrease from 0,29 ng/ml till 0,187 ng/ml and p0,01. Myocardial ischemia has been proven to be a very significant complication in SAH. Appropriate treatment of myocardial ischemia seems to improve systemic haemodynamics, as well as haemodynamics of the damaged brain. Acta Medica Medianae 2008;47(1):19-21. Key words: myocardial ischemia, treatment, spontaneous SAH Clinic of Neurosurgery, Clinical Center Nis The aim of this study was to prove the existence of myocardial ischemia in SAH as well as to examine the effects of cardio-specific therapy on such disorders. Contact: Anica Pavlovic 91 Narodnih heroja Street 18000 Nis, S