Prevalence and Risk Factors of Stress Cardiomyopathy After Convulsive Status Epilepticus in ICU Patients

Belcour, Dominique; Jabot, Julien; Grard, Benjamin; Roussiaux, A.; Ferdynus, Cyril; Vandroux, David; Vignon, Philippe

doi:10.1097/ccm.0000000000001191

Cited by 32 publications

(34 citation statements)

References 31 publications

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“…Hypervolemia requires diuretics or ultrafiltration while titrated intravenous vasodilators may reduce LV afterload, and hence the pressure gradient between the LV and the LA, and ultimately the volume of the associated MR [ 35 ]. Finally, CCE may depict the partial or full recovery of a transiently depressed LV systolic function, as in CPE secondary to an ischemic myocardial event or induced by a stress cardiomyopathy [ 36 ].…”

Section: Cardiogenic Pulmonary Edemamentioning

confidence: 99%

Critical care ultrasonography in acute respiratory failure

et al. 2016

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Acute respiratory failure (ARF) is a leading indication for performing critical care ultrasonography (CCUS) which, in these patients, combines critical care echocardiography (CCE) and chest ultrasonography. CCE is ideally suited to guide the diagnostic work-up in patients presenting with ARF since it allows the assessment of left ventricular filling pressure and pulmonary artery pressure, and the identification of a potential underlying cardiopathy. In addition, CCE precisely depicts the consequences of pulmonary vascular lesions on right ventricular function and helps in adjusting the ventilator settings in patients sustaining moderate-to-severe acute respiratory distress syndrome. Similarly, CCE helps in identifying patients at high risk of ventilator weaning failure, depicts the mechanisms of weaning pulmonary edema in those patients who fail a spontaneous breathing trial, and guides tailored therapeutic strategy. In all these clinical settings, CCE provides unparalleled information on both the efficacy and tolerance of therapeutic changes. Chest ultrasonography provides further insights into pleural and lung abnormalities associated with ARF, irrespective of its origin. It also allows the assessment of the effects of treatment on lung aeration or pleural effusions. The major limitation of lung ultrasonography is that it is currently based on a qualitative approach in the absence of standardized quantification parameters. CCE combined with chest ultrasonography rapidly provides highly relevant information in patients sustaining ARF. A pragmatic strategy based on the serial use of CCUS for the management of patients presenting with ARF of various origins is detailed in the present manuscript.

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Section: Cardiogenic Pulmonary Edemamentioning

confidence: 99%

Critical care ultrasonography in acute respiratory failure

et al. 2016

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“…Thus, it cannot be assessed if TTS was encouraged by lamotrigine overdose, which is known to affect the cardiac conduction system [11]. TTS in epileptic patients, however, occurs also in patients without antiepileptic therapy, thus it cannot be explained exclusively as a side effect of antiepileptic drugs [2,3]. From these findings and our case we conclude that TTS should be considered as a complication of epileptic seizures.…”

Section: Discussionmentioning

confidence: 76%

“…TTS predominantly affects elderly women and is often preceded by emotional or physical stress [1]. Epileptic seizures as triggering events of TTS have to date been described in nearly 100 cases [2,3]. The temporal association between epileptic seizure and onset of TTC is frequently unknown due to postictal somnolence or lack of cardiologic surveillance after a seizure.…”

Section: Introductionmentioning

confidence: 99%

Delayed onset of Takotsubo syndrome after epileptic seizure

Stöllberger

Finsterer

2018

Neurol Neurochir Pol.

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“…More recently, variants of SIC that exhibit mid-ventricular regional wall motion abnormalities have been identified [ 3 , 4 ]. Recent data suggests that SIC may be secondary to status epilepticus (SE) in up to 56% of cases [ 5 ]. Additionally, recurrence is associated with sudden unexplained death in epilepsy (SUDEP) in 3% of cases [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Recent data suggests that SIC may be secondary to status epilepticus (SE) in up to 56% of cases [ 5 ]. Additionally, recurrence is associated with sudden unexplained death in epilepsy (SUDEP) in 3% of cases [ 5 ]. It is important to note that a study by Belcour et al reports incidence of SIC in ICU patients admitted with convulsive status epilepticus, but these refractory cases do not represent all cases [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Recurrence of Postoperative Stress-Induced Cardiomyopathy Resulting from Status Epilepticus

Miller

Ahmed

Tarant

2017

Case Reports in Critical Care

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Introduction. Classically, stress-induced cardiomyopathy (SIC), also known as takotsubo cardiomyopathy, displays the pathognomonic feature of reversible left ventricular apical ballooning without coronary artery stenosis following stressful event(s). Temporary reduction in ejection fraction (EF) resolves spontaneously. Variants of SIC exhibiting mid-ventricular regional wall motion abnormalities have been identified. Recent case series present SIC as a finding in association with sudden unexplained death in epilepsy (SUDEP). This case presents a patient who develops recurrence of nonapical cardiomyopathy secondary to status epilepticus. Case Report. Involving a postoperative, postmenopausal woman having two distinct episodes of status epilepticus (SE) preceding two incidents of SIC. Preoperative transthoracic echocardiogram (TTE) confirms the patient's baseline EF of 60% prior to the second event. Postoperatively, SE occurs, and the initial electrocardiogram exhibits T-wave inversions with subsequent elevation of troponin I. Postoperative TTE shows an EF of 30% with mid-ventricular wall akinesia restoring baseline EF rapidly. Conclusion. This case identifies the need to understand SIC and its diagnostic criteria, especially when cardiac catheterization is neither indicated nor available. Sudden cardiac death should be considered as a possible complication of refractory status epilepticus. The pathophysiology in SUDEP is currently unknown; yet a correlation between SUDEP and SIC is hypothesized to exist.

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Prevalence and Risk Factors of Stress Cardiomyopathy After Convulsive Status Epilepticus in ICU Patients

Abstract: These results suggest that stress cardiomyopathy is common in patients admitted to the ICU for convulsive status epilepticus. Accordingly, these patients should be screened for stress cardiomyopathy and monitored if they present with hemodynamic compromise.

Cited by 32 publications

References 31 publications

Critical care ultrasonography in acute respiratory failure

Critical care ultrasonography in acute respiratory failure

Delayed onset of Takotsubo syndrome after epileptic seizure

Recurrence of Postoperative Stress-Induced Cardiomyopathy Resulting from Status Epilepticus

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