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.