Management recommendations to reduce cardiac risk in chronic epilepsy
Multifactorial lines of evidence in adults point to a critical linkage between chronic epilepsy and elevated risk for cardiovascular disease and premature cardiac death. Diverse pathophysiological processes appear to be involved that include accelerated atherosclerosis, myocardial infarction, abnorm...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Epilepsy & Behavior Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986424000959 |
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| author | Trudy D. Pang Richard L. Verrier Steven C. Schachter |
| author_facet | Trudy D. Pang Richard L. Verrier Steven C. Schachter |
| author_sort | Trudy D. Pang |
| collection | DOAJ |
| description | Multifactorial lines of evidence in adults point to a critical linkage between chronic epilepsy and elevated risk for cardiovascular disease and premature cardiac death. Diverse pathophysiological processes appear to be involved that include accelerated atherosclerosis, myocardial infarction, abnormal autonomic tone, heart failure, atrial and ventricular arrhythmias, and hyperlipidemia. Seizure-induced surges in catecholamines and hypoxia may be conducive to cardiovascular damage and the Epileptic Heart condition. The current review provides a systematic strategy for clinical management to reduce risk for cardiovascular disease in adult patients with epilepsy. The proposed approach includes adherence to cardiovascular risk guidelines, incorporation of standard monitoring using electrocardiographic and echocardiographic markers, and regular assessment of plasma lipid profiles. Attention is drawn to the arrhythmogenic risks associated with antiseizure medications (ASMs) with sodium channel blocking properties that can disrupt cardiac conduction and repolarization and predispose to ventricular and atrial arrhythmias. Caution is warranted regarding the use of enzyme-inducing ASMs that can increase plasma lipid levels. The ultimate goals of the proposed management recommendations are to mitigate cardiac risk and reduce premature cardiac death in individuals with chronic epilepsy. |
| format | Article |
| id | doaj-art-eb915fb30ede4430bfcc728bc188b310 |
| institution | Kabale University |
| issn | 2589-9864 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj-art-eb915fb30ede4430bfcc728bc188b3102025-02-02T05:29:12ZengElsevierEpilepsy & Behavior Reports2589-98642025-03-0129100738Management recommendations to reduce cardiac risk in chronic epilepsyTrudy D. Pang0Richard L. Verrier1Steven C. Schachter2Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA; Corresponding author.Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USADepartments of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Boston, MA, USAMultifactorial lines of evidence in adults point to a critical linkage between chronic epilepsy and elevated risk for cardiovascular disease and premature cardiac death. Diverse pathophysiological processes appear to be involved that include accelerated atherosclerosis, myocardial infarction, abnormal autonomic tone, heart failure, atrial and ventricular arrhythmias, and hyperlipidemia. Seizure-induced surges in catecholamines and hypoxia may be conducive to cardiovascular damage and the Epileptic Heart condition. The current review provides a systematic strategy for clinical management to reduce risk for cardiovascular disease in adult patients with epilepsy. The proposed approach includes adherence to cardiovascular risk guidelines, incorporation of standard monitoring using electrocardiographic and echocardiographic markers, and regular assessment of plasma lipid profiles. Attention is drawn to the arrhythmogenic risks associated with antiseizure medications (ASMs) with sodium channel blocking properties that can disrupt cardiac conduction and repolarization and predispose to ventricular and atrial arrhythmias. Caution is warranted regarding the use of enzyme-inducing ASMs that can increase plasma lipid levels. The ultimate goals of the proposed management recommendations are to mitigate cardiac risk and reduce premature cardiac death in individuals with chronic epilepsy.http://www.sciencedirect.com/science/article/pii/S2589986424000959ArrhythmiaEchocardiogramElectrocardiogramHyperlipidemiaHypertensionIschemic heart disease |
| spellingShingle | Trudy D. Pang Richard L. Verrier Steven C. Schachter Management recommendations to reduce cardiac risk in chronic epilepsy Epilepsy & Behavior Reports Arrhythmia Echocardiogram Electrocardiogram Hyperlipidemia Hypertension Ischemic heart disease |
| title | Management recommendations to reduce cardiac risk in chronic epilepsy |
| title_full | Management recommendations to reduce cardiac risk in chronic epilepsy |
| title_fullStr | Management recommendations to reduce cardiac risk in chronic epilepsy |
| title_full_unstemmed | Management recommendations to reduce cardiac risk in chronic epilepsy |
| title_short | Management recommendations to reduce cardiac risk in chronic epilepsy |
| title_sort | management recommendations to reduce cardiac risk in chronic epilepsy |
| topic | Arrhythmia Echocardiogram Electrocardiogram Hyperlipidemia Hypertension Ischemic heart disease |
| url | http://www.sciencedirect.com/science/article/pii/S2589986424000959 |
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