Neurogenic Cardiac Syndromes: Pathophysiology and Classification.

Neurogenic cardiac syndromes (NCS) encompass cardiac rhythm, functional, and hemodynamic abnormalities triggered or amplified by neurologic injury, autonomic dysfunction, or stress-related central nervous system activation. This article summarizes the brain-heart axis, shared mechanisms including sympathetic overactivation, vagal withdrawal, impaired heart rate variability and baroreflex sensitivity, neuroinflammation, endothelial dysfunction, and myocardial stunning, and proposes a practical classification framework. Acute brain injury-related, seizure-related, chronic autonomic failure-related, stress-related, and heart failure-associated NCS phenotypes are integrated to support earlier recognition, monitoring, and multidisciplinary management.