The Impact of Chronic Circulatory Impairment on Functioning of Central Nervous System

Abstract

Neurologic and psychologic dysfunctions were related to the degree of hemodynamic (cardio-circulatory) impairment More than 120 unselected consecutive rheumatic and congenital hospitalized cardiac patients were studied. Four hemodynamic measures of cardiac dysfunctions were selected for this study as the most representative of numerous such measurements. The following were correlated with the clinical ratings of the neurologic findings and with 12 psychologic tests: Cardiac Index and history of congestive heart failure for all cardiac patients; and mitral valve area and the presence of calcium and thrombi (in the left atrium at subsequent mitral valve surgery) for mitral valve patients. One out of 4 patients showed positive neurologic signs on careful examination. Neurologic dysfunctions correlated with the presence of calcium and thrombi in the mitral valve patient group and in cardiac patients, independent of etiology, with severe impairment of the cardiac index and with history of severe congestive heart failure. Probably both cerebral embolization and markedly diminished blood flow can lead to neurologic dysfunction. There were indications in the psychologic tests that a selective impairment of some aspects of intelligence may be present in severely impaired cardiac patients and may represent some deterioration in cortical functioning. There was some suggestion of possible disturbed personality functioning in severe cardiocirculatory dysfunction. No relationship was found between impaired cardiocirculatory functioning and perceptual-motor functions.