Cardiac manifestations after subarachnoid hemorrhage: a systematic review of the literature.

Cardiac alterations associated with subarachnoid hemorrhage (SAH) have been recognized and frequently reported. We systematically reviewed the literature on MEDLINE using the key words: SAH + (heart, cardiac, electrocardiogram, cardiac enzymes, troponin, myoglobin, echocardiography, scintigraphy, Holter, and regional wall motion abnormalities) and included all articles describing cardiac abnormalities in the course of SAH whether spontaneous or secondary. The diagnosis of SAH was established by computed tomography scan, lumbar puncture, or brain autopsy. Cardiac abnormalities were identified by electrocardiogram, enzymatic elevation, Holter monitoring, echocardiography, cardiac scintigraphy, coronary angiography, or autopsy. Despite the considerable literature describing cardiac alterations during the course of SAH, epidemiological, pathophysiological, and prognostic aspects are yet to be clarified. Further studies are needed to evaluate the magnitude of this problem.