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Acute reversible myocardial depression associated with sepsis
Makoto Kontani1, Yoshiaki Izumiya, Miho Shimizu
1Department of Cardiology, Tsuruga Municipal Hospital, 1-6-60 Mishima-cho, Tsuruga, Fukui 914-8502.
Internal Medicine (Tokyo, Japan)
|February 14, 2003
Summary
Sepsis can cause acute heart failure through septic myocardial depression, a condition where cytokines directly impair heart muscle function. Recovery from sepsis led to improved heart function in this patient.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Sepsis can lead to multi-organ dysfunction, including the cardiovascular system.
- Septic myocardial depression is a recognized complication of severe sepsis and septic shock.
Observation:
- A 30-year-old male presented with left lobar pneumonia and septic shock, developing acute left-sided heart failure.
- Echocardiography showed severe left ventricular hypokinesis, and hemodynamic monitoring indicated Forrester subset II.
- Serum levels of tumor necrosis factor-alpha and interleukin-6 were elevated.
Findings:
- Left ventricular function improved as sepsis resolved and inflammatory markers decreased.
- This suggests a direct role of cytokines in the observed myocardial dysfunction.
- The patient experienced recovery from septic myocardial depression.
Implications:
- Cytokine-induced myocardial depression is a significant factor in sepsis-related heart failure.
- Understanding this mechanism is crucial for managing critically ill septic patients.
- Targeting inflammatory pathways may offer therapeutic benefits in septic cardiomyopathy.