Conclusions
TC’s preferential effects on the sub-endocardial myocytes manifests as an increased propensity for arrhythmia; this combined with excessive catecholamines, which can induce arrhythmia even in healthy myocardium, may be a major cause of sudden death in neurologic disease including subarachnoid hemorrhage, stroke, head trauma and increased intracranial pressure. With the wealth of evidence connecting the brain’s effect on the heart, perhaps hyponatremia indirectly causes TC by first causing cerebral edema. The resulting neurological disturbance results in excessive catecholamine action on the myocardium which manifests as TC.