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Cardiac and pulmonary disturbances are common after SAH and are thought to be secondary to a surge in catechol- amine levels and sympathetic tone.166,167 Significant auto- nomic nervous system disturbance after SAH can result in changes in the electrocardiogram and lead to myocardial dysfunction.
in myocardial stunning.
High serum levels are associated with increased hemorrhage, hemodynamic fluctuations, and worse outcomes.172 Release of troponin can represent cardiac ischemia in patients with atherosclerotic heart dis- ease or a "myocardial leak" from neurogenic injury.172
Neurologic deterioration, poor out- comes, and increased mortality have been reported with baseline blood pressures less than 100/70 mm Hg.203 Com- mon causes of arterial hypotension include hypovolemia, blood loss, decreased cardiac output, myocardial infarc- tion, and arrhythmias.
Myocardial depression from cardiotoxicity of seizure treat- ments may require additional cardiac monitoring and vaso- pressor support.
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