Transient Coronary Microvascular Dysfunction in Septic Shock

Sepsis is a dysregulated hyperinflammatory response to infection that leads to widespread endothelial damage with impaired microcirculation and organ perfusion. The extent of coronary microvascular dysfunction in sepsis remains largely unexplored.

We present a case of pneumococcal pneumonia complicated by septic shock, where coronary microvascular function was invasively assessed using the thermodilution technique. We observed transient dysfunction in the coronary microcirculation during the transition from the acute to recovery phases of septic shock.

This transient dysfunction does not necessarily signify full coronary microvascular recovery because acute inflammation may lead to long-term changes in vascular structure. This case provides novel insights into cardiac microvascular involvement in sepsis and highlights the importance of further research on its impact on patient outcomes.

Sepsis can cause coronary microvascular dysfunction, even with preserved left ventricular ejection fraction. Sepsis-induced coronary microvascular dysfunction can resolve during the recovery phase.