Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 1989 Feb;81(2):193–197.

Neurologic complications of cardiovascular diseases.

W R Slade Jr, A C McNeal, P S Tse
PMCID: PMC2625964  PMID: 2659808

Abstract

Neurocardiology considers the interrelationships between the circulatory and nervous systems. An appreciation of the anatomic relationship preceded the concept of the clinical relationship of the two systems. Epidemiologic studies link risk factors of the cardiovascular and nervous systems. Neurologic signs and symptoms are often the presenting indication of cardiovascular disease. Neurologic complications occur during the natural history of cardiovascular disease, during diagnostic evaluation, and in the treatment process. A knowledge of potential complications as well as their frequency will help the physician make ethical and valid recommendations to patients concerning their management. This article highlights some of the potential complications that may be encountered in the management of patients with cardiovascular diseases.

Full text

PDF
193

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aberg T., Ronquist G., Tydén H., Brunnkvist S., Hultman J., Bergström K., Lilja A. Adverse effects on the brain in cardiac operations as assessed by biochemical, psychometric, and radiologic methods. J Thorac Cardiovasc Surg. 1984 Jan;87(1):99–105. [PubMed] [Google Scholar]
  2. Adams D. F., Fraser D. B., Abrams H. L. The complications of coronary arteriography. Circulation. 1973 Sep;48(3):609–618. doi: 10.1161/01.cir.48.3.609. [DOI] [PubMed] [Google Scholar]
  3. Barnett H. J., Jones M. W., Boughner D. R., Kostuk W. J. Cerebral ischemic events associated with prolapsing mitral valve. Arch Neurol. 1976 Nov;33(11):777–782. doi: 10.1001/archneur.1976.00500110045008. [DOI] [PubMed] [Google Scholar]
  4. Benson L. N., Freedom R. M., Wilson G. J., Halliday W. C. Cerebral complications following balloon angioplasty of coarctation of the aorta. Cardiovasc Intervent Radiol. 1986;9(4):184–186. doi: 10.1007/BF02577937. [DOI] [PubMed] [Google Scholar]
  5. Breuer A. C., Furlan A. J., Hanson M. R., Lederman R. J., Loop F. D., Cosgrove D. M., Greenstreet R. L., Estafanous F. G. Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients. Stroke. 1983 Sep-Oct;14(5):682–687. doi: 10.1161/01.str.14.5.682. [DOI] [PubMed] [Google Scholar]
  6. Britt R. H., Enzmann D. R., Remington J. S. Intracranial infection in cardiac transplant recipients. Ann Neurol. 1981 Feb;9(2):107–119. doi: 10.1002/ana.410090203. [DOI] [PubMed] [Google Scholar]
  7. CLARK D. B., TYLER H. R. Incidence of neurological complications in congenital heart disease. AMA Arch Neurol Psychiatry. 1957 Jan;77(1):17–22. doi: 10.1001/archneurpsyc.1957.02330310027003. [DOI] [PubMed] [Google Scholar]
  8. COSNETT J. E., PUDIFIN D. J. EMBOLIC COMPLICATIONS OF CARDIOMYOPATHY. Br Heart J. 1964 Jul;26:544–548. doi: 10.1136/hrt.26.4.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Coffey C. E., Massey E. W., Roberts K. B., Curtis S., Jones R. H., Pryor D. B. Natural history of cerebral complications of coronary artery bypass graft surgery. Neurology. 1983 Nov;33(11):1416–1421. doi: 10.1212/wnl.33.11.1416. [DOI] [PubMed] [Google Scholar]
  10. Currie P., Ramsdale D. R. Paranoid psychosis induced by tocainide. Br Med J (Clin Res Ed) 1984 Feb 25;288(6417):606–607. doi: 10.1136/bmj.288.6417.606. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. DOTTER C. T., JUDKINS M. P. TRANSLUMINAL TREATMENT OF ARTERIOSCLEROTIC OBSTRUCTION. DESCRIPTION OF A NEW TECHNIC AND A PRELIMINARY REPORT OF ITS APPLICATION. Circulation. 1964 Nov;30:654–670. doi: 10.1161/01.cir.30.5.654. [DOI] [PubMed] [Google Scholar]
  12. Dawson D. M., Fischer E. G. Neurologic complications of cardiac catheterization. Neurology. 1977 May;27(5):496–497. doi: 10.1212/wnl.27.5.496. [DOI] [PubMed] [Google Scholar]
  13. DeVries W. C., Anderson J. L., Joyce L. D., Anderson F. L., Hammond E. H., Jarvik R. K., Kolff W. J. Clinical use of the total artificial heart. N Engl J Med. 1984 Feb 2;310(5):273–278. doi: 10.1056/NEJM198402023100501. [DOI] [PubMed] [Google Scholar]
  14. Drachman D. A., Skom J. H. Procainamide---a hazard in myasthenia gravis. Arch Neurol. 1965 Sep;13(3):316–320. doi: 10.1001/archneur.1965.00470030096010. [DOI] [PubMed] [Google Scholar]
  15. Dunnigan A., Pritzker M. R., Benditt D. G., Benson D. W., Jr Life threatening ventricular tachycardias in late survivors of surgically corrected tetralogy of Fallot. Br Heart J. 1984 Aug;52(2):198–206. doi: 10.1136/hrt.52.2.198. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Edmunds L. H., Jr Thromboembolic complications of current cardiac valvular prostheses. Ann Thorac Surg. 1982 Jul;34(1):96–106. doi: 10.1016/s0003-4975(10)60862-4. [DOI] [PubMed] [Google Scholar]
  17. Eisendrath S. J., Gershengorn K. N., Unger R. Digoxin-induced organic brain syndrome. Am Heart J. 1983 Aug;106(2):419–420. doi: 10.1016/0002-8703(83)90218-1. [DOI] [PubMed] [Google Scholar]
  18. Fisher C. M. Visual disturbances associated with quinidine and quinine. Neurology. 1981 Dec;31(12):1569–1571. doi: 10.1212/wnl.31.12.1569. [DOI] [PubMed] [Google Scholar]
  19. Furlan A. J., Breuer A. C. Central nervous system complications of open heart surgery. Stroke. 1984 Sep-Oct;15(5):912–915. doi: 10.1161/01.str.15.5.912. [DOI] [PubMed] [Google Scholar]
  20. Furlan A. J., Craciun A. R., Salcedo E. E., Mellino M. Risk of stroke in patients with mitral annulus calcification. Stroke. 1984 Sep-Oct;15(5):801–803. doi: 10.1161/01.str.15.5.801. [DOI] [PubMed] [Google Scholar]
  21. Galbreath C., Salgado E. D., Furlan A. J., Hollman J. Central nervous system complications of percutaneous transluminal coronary angioplasty. Stroke. 1986 Jul-Aug;17(4):616–619. doi: 10.1161/01.str.17.4.616. [DOI] [PubMed] [Google Scholar]
  22. González-Scarano F., Hurtig H. I. Neurologic complications of coronary artery bypass grafting: case-control study. Neurology. 1981 Aug;31(8):1032–1035. doi: 10.1212/wnl.31.8.1032. [DOI] [PubMed] [Google Scholar]
  23. Govier A. V., Reves J. G., McKay R. D., Karp R. B., Zorn G. L., Morawetz R. B., Smith L. R., Adams M., Freeman A. M. Factors and their influence on regional cerebral blood flow during nonpulsatile cardiopulmonary bypass. Ann Thorac Surg. 1984 Dec;38(6):592–600. doi: 10.1016/s0003-4975(10)62316-8. [DOI] [PubMed] [Google Scholar]
  24. Gwost J., Stoebe T., Chesler E., Weir E. K. Analysis of the complications of cardiac catheterization over nine years. Cathet Cardiovasc Diagn. 1982;8(1):13–21. doi: 10.1002/ccd.1810080104. [DOI] [PubMed] [Google Scholar]
  25. Harris L., McKenna W. J., Rowland E., Krikler D. M. Side effects and possible contraindications of amiodarone use. Am Heart J. 1983 Oct;106(4 Pt 2):916–923. doi: 10.1016/0002-8703(83)90016-9. [DOI] [PubMed] [Google Scholar]
  26. Hinton R. C., Kistler J. P., Fallon J. T., Friedlich A. L., Fisher C. M. Influence of etiology of atrial fibrillation on incidence of systemic embolism. Am J Cardiol. 1977 Oct;40(4):509–513. doi: 10.1016/0002-9149(77)90064-9. [DOI] [PubMed] [Google Scholar]
  27. Hotson J. R., Pedley T. A. The neurological complications of cardiac transplantation. Brain. 1976 Dec;99(4):673–694. doi: 10.1093/brain/99.4.673. [DOI] [PubMed] [Google Scholar]
  28. Iliceto S., Antonelli G., Sorino M., Calabrese P., Biasco G., Rizzon P. Two-dimensional echocardiographic recognition of complications of cardiac invasive procedures. Am J Cardiol. 1984 Mar 1;53(6):846–848. doi: 10.1016/0002-9149(84)90417-x. [DOI] [PubMed] [Google Scholar]
  29. Iliceto S., Antonelli G., Sorino M., Calabrese P., Biasco G., Rizzon P. Two-dimensional echocardiographic recognition of complications of cardiac invasive procedures. Am J Cardiol. 1984 Mar 1;53(6):846–848. doi: 10.1016/0002-9149(84)90417-x. [DOI] [PubMed] [Google Scholar]
  30. Jones H. R., Jr, Caplan L. R., Come P. C., Swinton N. W., Jr, Breslin D. J. Cerebral emboli of paradoxical origin. Ann Neurol. 1983 Mar;13(3):314–319. doi: 10.1002/ana.410130315. [DOI] [PubMed] [Google Scholar]
  31. Joyce L. D., Nelson R. M. Comparison of porcine valve xenografts with mechanical prostheses. A 7 1/2 year experience. J Thorac Cardiovasc Surg. 1984 Jul;88(1):102–113. [PubMed] [Google Scholar]
  32. Kannel W. B., Abbott R. D., Savage D. D., McNamara P. M. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med. 1982 Apr 29;306(17):1018–1022. doi: 10.1056/NEJM198204293061703. [DOI] [PubMed] [Google Scholar]
  33. Kennedy J. W. Complications associated with cardiac catheterization and angiography. Cathet Cardiovasc Diagn. 1982;8(1):5–11. doi: 10.1002/ccd.1810080103. [DOI] [PubMed] [Google Scholar]
  34. Kerr D. J., Elliott H. L., Hillis W. S. Epileptiform seizures and electroencephalographic abnormalities as manifestations of digoxin toxicity. Br Med J (Clin Res Ed) 1982 Jan 16;284(6310):162–163. doi: 10.1136/bmj.284.6310.162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Kuritzky R. A., Laks M. M., McIntyre H. The neurologic complications of cardiovascular disease. Prim Care. 1984 Dec;11(4):681–692. [PubMed] [Google Scholar]
  36. Lanza R. P., Cooper D. K., Cassidy M. J., Barnard C. N. Malignant neoplasms occurring after cardiac transplantation. JAMA. 1983 Apr 1;249(13):1746–1748. [PubMed] [Google Scholar]
  37. Martinez-Arizala A., Sobol S. M., McCarty G. E., Nichols B. R., Rakita L. Amiodarone neuropathy. Neurology. 1983 May;33(5):643–645. doi: 10.1212/wnl.33.5.643. [DOI] [PubMed] [Google Scholar]
  38. McAllen P. M., Marshall J. Cardiac dysrhythmia and transient cerebral ischaemic attacks. Lancet. 1973 Jun 2;1(7814):1212–1214. doi: 10.1016/s0140-6736(73)90527-8. [DOI] [PubMed] [Google Scholar]
  39. Montero C. G., Martinez A. J. Neuropathology of heart transplantation: 23 cases. Neurology. 1986 Sep;36(9):1149–1154. doi: 10.1212/wnl.36.9.1149. [DOI] [PubMed] [Google Scholar]
  40. Mulligan B., Espinosa G. A., Mafee M. Prevention of brachial plexus injury during transaxillary artery catheterization. Mil Med. 1983 Jun;148(6):518–520. [PubMed] [Google Scholar]
  41. Nicholls E. S., Johansen H. L. Implications of changing trends in cerebrovascular and ischemic heart disease mortality. Stroke. 1983 Mar-Apr;14(2):153–156. doi: 10.1161/01.str.14.2.153. [DOI] [PubMed] [Google Scholar]
  42. Oyer P. E., Stinson E. B., Reitz B. A., Miller D. C., Rossiter S. J., Shumway N. E. Long-term evaluation of the porcine xenograft bioprosthesis. J Thorac Cardiovasc Surg. 1979 Sep;78(3):343–350. [PubMed] [Google Scholar]
  43. Pennock J. L., Oyer P. E., Reitz B. A., Jamieson S. W., Bieber C. P., Wallwork J., Stinson E. B., Shumway N. E. Cardiac transplantation in perspective for the future. Survival, complications, rehabilitation, and cost. J Thorac Cardiovasc Surg. 1982 Feb;83(2):168–177. [PubMed] [Google Scholar]
  44. Pottash A. L., Black H. R., Gold M. S. Psychiatric complications of antihypertensive medications. J Nerv Ment Dis. 1981 Jul;169(7):430–438. doi: 10.1097/00005053-198107000-00004. [DOI] [PubMed] [Google Scholar]
  45. Pruitt A. A., Rubin R. H., Karchmer A. W., Duncan G. W. Neurologic complications of bacterial endocarditis. Medicine (Baltimore) 1978 Jul;57(4):329–343. doi: 10.1097/00005792-197807000-00004. [DOI] [PubMed] [Google Scholar]
  46. Raeder E. A., Podrid P. J., Lown B. Side effects and complications of amiodarone therapy. Am Heart J. 1985 May;109(5 Pt 1):975–983. doi: 10.1016/0002-8703(85)90238-8. [DOI] [PubMed] [Google Scholar]
  47. Sandok B. A., von Estorff I., Giuliani E. R. CNS embolism due to atrial myxoma: clinical features and diagnosis. Arch Neurol. 1980 Aug;37(8):485–488. doi: 10.1001/archneur.1980.00500570033004. [DOI] [PubMed] [Google Scholar]
  48. Silver M. A., Macher A. M., Reichert C. M., Levens D. L., Parrillo J. E., Longo D. L., Roberts W. C. Cardiac involvement by Kaposi's sarcoma in acquired immune deficiency syndrome (AIDS). Am J Cardiol. 1984 Mar 15;53(7):983–985. doi: 10.1016/0002-9149(84)90554-x. [DOI] [PubMed] [Google Scholar]
  49. Simpson W. T. Nature and incidence of unwanted effects with atenolol. Postgrad Med J. 1977;53 (Suppl 3):162–167. [PubMed] [Google Scholar]
  50. Stinson E. B., Griepp R. B., Shumway N. E. Clinical experience with a porcine aortic valve xenograft for mitral valve replacement. Ann Thorac Surg. 1974 Oct;18(4):391–401. doi: 10.1016/s0003-4975(10)64376-7. [DOI] [PubMed] [Google Scholar]
  51. Sundaram M. B., McMeekin J. D., Gulamhusein S. Cardiac tachyarrhythmias in hereditary long QT syndromes presenting as a seizure disorder. Can J Neurol Sci. 1986 Aug;13(3):262–263. doi: 10.1017/s0317167100036398. [DOI] [PubMed] [Google Scholar]
  52. Swift T. R. Disorders of neuromuscular transmission other than myasthenia gravis. Muscle Nerve. 1981 Jul-Aug;4(4):334–353. doi: 10.1002/mus.880040410. [DOI] [PubMed] [Google Scholar]
  53. Williams R. A. Cardiovascular diseases and their neurological complications. Bull Los Angeles Neurol Soc. 1980;45:1–4. [PubMed] [Google Scholar]
  54. Wolf P. A., Dawber T. R., Kannel W. B. Heart disease as a precursor of stroke. Adv Neurol. 1978;19:567–577. [PubMed] [Google Scholar]
  55. Wolf P. A., Dawber T. R., Thomas H. E., Jr, Kannel W. B. Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study. Neurology. 1978 Oct;28(10):973–977. doi: 10.1212/wnl.28.10.973. [DOI] [PubMed] [Google Scholar]
  56. de Bono D. P., Warlow C. P. Mitral-annulus calcification and cerebral or retinal ischaemia. Lancet. 1979 Aug 25;2(8139):383–385. doi: 10.1016/s0140-6736(79)90402-1. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES