29. SEPTIC CARDIOMYOPATHY: A CASE REPORT AND REVIEW
Main Article Content
Abstract
Background: Sepsis is significant cause of mortality in intensive care units. Septic cardiomyopathy is a severe complication of sepsis, with the report prevalence from 10 to 70%. Despite the lack of the diagnostic criteria and therapeutic protocols, septic cardiomyopathy may be defined as depressed intrinsic contractility induced by sepsis. However, the significance of septic cardiomyopathy has not been adequately recognized, without comprehensive researchs on its diagnosis, prognosis, and guideline management. We report a clinical case of a 72-years-old male patient diagnosed with septic shock due to perforated gastric peritonitis. Postoperatively, the patient developed circulatory collapse and depressed left ventricular ejection fraction (EF 39%), unresponsive to fluid resuscitation, vasopressors, and standard medical treatments, resulting in death after 9 days of treatment. Through this case study, we aim to review the recent literature focusing on the diagnosis and treatments of septic cardiomyopathy.
Conclusion: Echocardiography is the gold standard for diagnosing myocarditis secondary to systemic infection. We should consider this diagnosis and perform necessary investigations if hemodynamic instability is refractory to fluid resuscitation and vasopressors. Early diagnosis and appropriate treatment strategies based on current guidelines and emerging research are crucial.
Article Details
Keywords
Septic cardiomyopathy, sepsis, septic shock
References
[2] Holland EM, Moss TJ, Acute noncardiovascular illness in the cardiac intensive care unit, J Am Coll Cardiol, 2017, 69(16): 1999-2007.
[3] L’Heureux M, Sternberg M, Brath L, Turlington J, Kashiouris MG, Sepsis-Induced Cardiomyopathy: a Comprehensive Review, Curr Cardiol
Rep, 2020, 22(5): 35. doi:10.1007/s11886-020-01277-2.
[4] Khalid N, Patel PD, Alghareeb R, Hussain A, Maheshwari M V, The effect of sepsis on myocardial function: a review of pathophysiology,
diagnostic criteria, and treatment, Cureus, 2022, 14(6).
[5] Weil MH, Nishjima H, Cardiac output in bacterial shock, Am J Med. , 1978, 64(6): 920-922.
[6] Hellman T, Uusalo P, Järvisalo MJ, Renal replacement techniques in septic shock, Int J Mol Sci., 2021, 22(19): 10238.
[7] Singer M, Deutschman CS, Seymour CW et al, The third international consensus definitions for sepsis and septic shock (Sepsis-3), JAMA, 2016, 315(8): 801-810.
[8] Bréchot N, Luyt CE, Schmidt M et al, Venoarterial extracorporeal membrane oxygenation support for refractory cardiovascular dysfunction during severe bacterial septic shock, Crit Care
Med., 2013, 41(7): 1616-1626.