Case Studies in Cardiac Dysfunction After Acute Aneurysmal Subarachnoid Hemorrhage

~ Exam ~

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Learning Objectives

After reading this article, learners will be able to:

  1. Recognize the pathology that may lead to cardiopulmonary compromise in patients with acute SAH and identify the clinical symptoms that may result.
  2. Differentiate the various tests used to evaluate a patient with cardiopulmonary compromise.
  3. Integrate methods of preserving cerebral perfusion with optimizing cardiopulmonary function.
1. A theory that is commonly accepted for the cascade of events that include cardiopulmonary compromise in patients with acute SAH is a:

  a. Electrical surge.
  b. Parasympathetic surge.
  c. Catecholamine surge.
  d. Thyroid storm.

2. Sympathetic stimulation is responsible for alterations in heart rate, body temperature, blood pressure, respiratory rate, pupil size and level of consciousness.

  a. True.

  b. False.

3. Sympathetic stimulation is thought to occur with an increase in which of the following?

  a. Heart rate.
  b. Blood pressure.
  c. Glucose.
  d. Intracranial Pressure.
4. Inadequate cardiac function (low cardiac output) following SAH, that eventually resolves is referred to as:

  a. Right heart failure.
  b. Stunned myocardium.
  c. Myocardial infarction.
  d. Cardiomyopathy.
5. This sensitive and widely accepted marker of cardiac injury, has been associated with an increased risk of cardiopulmonary complications following SAH.

  a. CPK.
  b. Magnesium.
  c. TSH.
  d. Troponin.
6. This type of diagnostic test reveals areas of ischemia and dilation of the heart and evaluates heart function by determining ejection fraction (EF) and wall motion.

  a. Cardiac catheterization.
  b. Cardiac stress test.
  c. Electrocardiogram.
  d. Echocardiogram.
7. Cardiopulmonary dysfunction after SAH is not only found in patients with preexisting heart disease.

  a. True.
  b. False.

8. In patients with SAH the complication of primary concern to the neuroscience practitioner is

  a. Pneumonia.
  b. Vasospasm.
  c. Renal Failure.
  d. GI Bleeding.
9. Inotropic and vasopressor agents used in patients with SAH include:

  a. epinephrine, norepinephrine, phenylephrine and dobutamine.
  b. nicardipine, epinephrine, phenylephrine and norepinephrine.

  c. nipride, dobutamine, norepinehrine and epinephrine.
  d. epinephrine, norepinephrine, lasix and labetolol.

10. The challenge for neuroscience practitioners is concomitantly managing cerebral and cardiopulmonary conditions, optimizing blood flow to tissue in one area without administering treatment that will decrease perfusion in the other.

  a. True.
  b. False.