BrainWaves #13 The broken heart syndrome

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 23, 2018

When the heart stops working, the brain stops working. But if the brain stops working, does the heart shut down? In this episode, Dr. David Manly (Duke Cardiology) discusses the pathogenesis and management of the reversible syndromes of neurogenic stress cardiomyopathy. In full disclosure, this is a re-mastered re-run of a prior episode posted June 29, 2016, with some updates at the end.

Produced by James E Siegler. Music by Lee Rosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

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Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P, et al. Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy. JAMA 2011;306(3):277-86. PMID 21771988

Finsterer J, Wahbi K. CNS-disease affecting the heart: brain-heart disorders. J Neurol Sci 2014;345(1-2):8-14. PMID 25034054

Grabowski A, Kilian J, Strank C, Cieslinski G, Meyding-Lamadé U. Takotsubo cardiomyopathy--a rare cause of cardioembolic stroke. Cerebrovasc Dis 2007;24(1):146-8. PMID 17565206

Lyon AR, Rees PS, Prasad S, Poole-Wilson PA, Harding SE. Stress (Takotsubo) cardiomyopathy--a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med 2008;5(1):22-9. PMID 18094670

Paur H, Wright PT, Sikkel MB, et al. High levels of circulating epinephrine trigger apical cardiodepression in a β2-adrenergic receptor/Gi-dependent manner: a new model of Takotsubo cardiomyopathy. Circulation 2012;126(6):697-706. PMID 22732314

Stiermaier T, Moeller C, Oehler K, et al. Long-term excess mortality in takotsubo cardiomyopathy: predictors, causes and clinical consequences. Eur J Heart Fail 2016;18(6):650-6. PMID 26990821

Yoshimura S, Toyoda K, Ohara T, et al. Takotsubo cardiomyopathy in acute ischemic stroke. Ann Neurol 2008;64(5):547-54. PMID 18688801

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.