[ECG signs mimicking acute coronary syndrome in septic cardiomyopathies]
János Tomcsányi1, Hrisula Arabadzisz1, Péter Arányi1
11 Betegápoló Irgalmasrend Budai Irgalmasrendi Kórháza, Kardiológia Budapest, Árpád fejedelem u. 7. II. em., 1023 Magyarország.
Insights
Sepsis can cause septic cardiomyopathy, mimicking heart attacks with ECG and troponin changes. Early sepsis treatment is crucial, not immediate coronary angiography, to reduce high hospital mortality.
Area of Science:
- Cardiology
- Infectious Diseases
Background:
- Septic cardiomyopathy is a serious complication of sepsis.
- It can present with electrocardiogram (ECG) and troponin elevations that mimic acute coronary syndrome.
- These changes may occur without significant coronary artery stenosis.
Purpose of the Study:
- To highlight four cases of septic cardiomyopathy.
- To emphasize the importance of recognizing ECG and troponin abnormalities in sepsis.
- To underscore the need for early sepsis management over immediate coronary angiography.
Main Methods:
- Case series presentation.
- Review of clinical data, ECG findings, troponin levels, and cardiac status in four patients with sepsis.
- Analysis of diagnostic and treatment approaches.
Main Results:
- Patients presented with symptoms mimicking acute coronary syndrome, including ECG changes and elevated troponin.
- No significant coronary artery stenosis was found in these cases.
- Septic cardiomyopathy was attributed to vascular involvement and cellular damage from sepsis.
Conclusions:
- Septic cardiomyopathy can present without chest pain, mimicking myocardial infarction.
- Early and adequate sepsis treatment is paramount for improving outcomes and reducing mortality.
- Focusing on immediate coronary angiography may delay essential sepsis management.
Abstract:
The authors present four cases of septic cardiomyopathy. These presentations highlight that patients without chest pain may have ECG and troponin elevations mimicking acute coronary artery syndrome without significant stenosis of coronaries in the background. This supports the experimental observation that sepsis is caused by vascular involvement and cellular damage behind septic cardiomyopathy. This underlines the importance of the fact that in these cases the primary focus should not be on immediate coronary angiography, but on adequate, early treatment of sepsis. Otherwise, hospital mortality will be very high. Since only a few ECG abnormalities in septic cardiomyopathy are published, the authors consider these important to publish. Orv Hetil. 2024; 165(47): 1871–1876.
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