Neurological complications of cardiac disease (heart brain disorders)

BACKGROUND: Heart disease is a frequent cause of cerebral compromise. This review aimed at summarising and discussing available data about heart brain disorders. METHODS: We performed a literature search in conventional databases. RESULTS: Frequent cerebral complications of cardiac disease include embolic stroke, syncope, and intracerebral bleeding. Rare complications are watershed infarction, brain abscess, meningitis, metastasis, dementia, or aneurysm formation. The most frequent and most well-known cardiac cause of neurological complications is cardiac embolism. Cardiac emboli can be of different material and derive from the left atrium, left atrial appendage, left ventricle, or the mitral or aortic valves. Also arrhythmias such as atrial fibrillation or atrial flutter may give rise to thrombus formation. Heart failure, myocardial infarction, myocardial aneurysm, endocarditis/myocarditis, and noncompaction are further causes of cerebral embolism. Another cardiac cause of neurological complications is low output failure due to systolic dysfunction, arrhythmias, or valve stenosis. Arrhythmias are not only associated with intra-cardiac thrombus formation but may also lead to low output failure and consecutively to watershed infarction, vertigo, fainting, or syncope. Valve abnormalities can be another source of neurological disease. CONCLUSION: The cardiologist must know about the neurological complications of heart disease and the neurologist must know about the cardiac causes of cerebral abnormalities. Heart-brain disorders require a bidisciplinary diagnostic and therapeutic approach.