Current challenges in understanding, diagnosing and managing sepsis-induced cardiac dysfunction

Area of Science:

• Cardiology
• Critical Care Medicine
• Pathophysiology

Background:

• Sepsis is a life-threatening condition with frequent cardiovascular complications.
• Sepsis-induced cardiac dysfunction (SICD) is a common but poorly understood complication.
• Existing diagnostic tools have limitations in identifying SICD.

Purpose of the Study:

• To review the diagnostic challenges of SICD.
• To discuss the prognosis and propose a diagnostic pathway for SICD.
• To highlight the limitations of current biomarkers and scoring systems for SICD.

Main Methods:

• Literature review focusing on diagnosis, prognosis, and management of SICD.
• Analysis of existing biomarkers (troponin, natriuretic peptides) and electrocardiogram (ECG) findings in sepsis.
• Emphasis on echocardiography as a primary diagnostic tool for SICD.

Main Results:

• Current severity scoring systems do not predict cardiac dysfunction in sepsis.
• Biomarkers like troponin and natriuretic peptides are insufficient for SICD diagnosis.
• Echocardiography is crucial for identifying reversible cardiac dysfunction in sepsis.
• Sepsis is a risk factor for new-onset atrial fibrillation.

Conclusions:

• Accurate diagnosis of SICD remains challenging.
• A combination of clinical, biochemical, and imaging data is not yet validated for SICD diagnosis.
• Repeat echocardiography is essential for diagnosing and monitoring SICD.