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Transient Coronary Microvascular Dysfunction in Septic Shock.

Samantha Lörstad¹, Sara Tehrani¹, Christina Ekenbäck²

¹Division of Internal Medicine, Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden.

JACC. Case Reports

|June 13, 2025

Summary

This summary is machine-generated.

Sepsis can cause temporary coronary microvascular dysfunction, even with normal heart function. This dysfunction may resolve during recovery, but long-term vascular changes are possible.

Keywords:

acute coronary syndrome atherosclerosis cardiac risk cardiomyopathy circulation coronary angiography coronary circulation fractional flow reserve myocardial ischemia perfusion

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Area of Science:

Cardiology
Critical Care Medicine
Infectious Diseases

Background:

Sepsis triggers a hyperinflammatory response, causing endothelial damage and impairing microcirculation.
Coronary microvascular dysfunction in sepsis is not well understood.
Assessing coronary microvascular function is crucial for understanding sepsis's cardiac impact.

Observation:

A case of pneumococcal pneumonia with septic shock was studied.
Coronary microvascular function was invasively assessed using thermodilution.
Transient coronary microvascular dysfunction was observed during septic shock recovery.

Findings:

Sepsis can induce coronary microvascular dysfunction, irrespective of left ventricular ejection fraction.
This dysfunction may be transient and resolve during the recovery phase.
Acute inflammation in sepsis may lead to lasting vascular structural alterations.

Implications:

This case offers new insights into cardiac microvascular involvement during sepsis.
Further research is needed to understand the long-term effects on patient outcomes.
Coronary microvascular dysfunction in sepsis warrants clinical attention and investigation.