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Cardiac Implications of Neurological Disease

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Textbook of Neurointensive Care

Abstract

For a long time, empirical observation and popular wisdom have suggested a tight link between neurological disease and cardiac complications, yet only in recent years has the improvement of knowledge supported by new technical approaches allowed a more detailed insight in the mechanisms underlying such connection. Both acute and chronic brain diseases may have relevant impacts on heart eliciting arrhythmias as well as myocardial ischemia, which might have catastrophic consequences. In this chapter, we will illustrate the most frequent acute and chronic neurological diseases in which clinical relevant cardiac complications manifest. In the first section, the physiological basis of the complex and intriguing relationship between heart and brain under physiological conditions will be discussed. Thereafter, we will focus on cerebrovascular accidents, along with traumatic brain and spinal cord injury, epilepsy, immune-mediated polyradiculoneuropathies, and myasthenia gravis, which represent the most frequent categories for acute neurocardiac complications. In the second part of this chapter, recent additions to our knowledge on dysautonomia and myocardial denervation observed in neurological degenerative disease will be illustrated. A better understanding of the intimate connections between brain and heart is the basis for a more affective prevention of cardiac complications in patients with neurological disease and customized therapeutical interventions of neurological diseases.

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Authors and Affiliations

  1. Department of Neurology and Stroke Unit, Ospedale S. Eugenio-ASL RMC, P.le dell’Umanesimo 10, Rome, 00144, Italy

    Cesare Iani MD & Ennio Montinaro MD

  2. Department of Neurology and Stroke Unit, Ospedale S. Eugenio-ASL RMC, Via Hugo Pratt 66, Rome, 00144, Italy

    Novella Bonaffini MD

  3. Division of Cardiology, Department of Medicine, Ospedale S. Eugenio-ASL RMC, P.le dell’Umanesimo 10, Rome, 00144, Italy

    Achille Gaspardone MPhil, MD, FESC, FACC, EAPCI

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  1. Cesare Iani MD
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  2. Ennio Montinaro MD
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  3. Novella Bonaffini MD
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  4. Achille Gaspardone MPhil, MD, FESC, FACC, EAPCI
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Correspondence to Achille Gaspardone MPhil, MD, FESC, FACC, EAPCI .

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Editors and Affiliations

  1. Pulmonary and Critical Care Medicine, Geisinger Health System, Danville, Pennsylvania, USA

    A Joseph Layon

  2. Departments of Anesthesiology & Surgery, University of Florida College of Medicine, Gainesville, Florida, USA

    Andrea Gabrielli

  3. Department of Neurosurgery, University of Florida, Gainesville, Florida, USA

    William A. Friedman

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Iani, C., Montinaro, E., Bonaffini, N., Gaspardone, A. (2013). Cardiac Implications of Neurological Disease. In: Layon, A., Gabrielli, A., Friedman, W. (eds) Textbook of Neurointensive Care. Springer, London. https://doi.org/10.1007/978-1-4471-5226-2_13

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