108 Acute Right Ventricular Cardiomyopathy in Patients With Severe Sepsis

Abstract

Introduction There is an increasing awareness that the cardiovascular pathophysiology of sepsis extends beyond vasodilatation and distributive shock. Acute left ventricular systolic dysfunction is seen in 40-60% of patients admitted to critical care who require organ support. The exact distribution, timing and aetiology of this phenomenon remain unclear as does the therapeutic implications. Although often affecting the left ventricle, cases describing synchronous biventricular or isolated right ventricular dysfunction have been described. This septic cardiomyopathy appears to be fully reversible in survivors. We describe three cases admitted to our intensive care unit who were demonstrated to have an acute isolated dilated right ventricular cardiomyopathy using trans thoracic echocardiography. Methods and results 3 patients admitted to the Adult ICU were echoed on admission to the ICU, all with severe sepsis and multi organ failure. Two required invasive ventilation, all three required inotrope and vasopressor support, with two requiring haemofiltration. All patients had CT contrast pulmonary angiography to exclude pulmonary embolus as a differential diagnosis. The source

Clostridium perfringens sepsis complicated by right ventricular cardiogenic shock

“…shock which to the best of our knowledge is the first description of this in C. perfringens sepsis. We have already reported similar findings in three other patients 23 with septic shock. This case underlines the crucial role that TTE plays in septic shock, independently assessing the ventricular function and reliably guiding resuscitation.…”

“…Of particular interest to our case is the aetiology of the patient’s RV failure resulting in cardiovascular shock which to the best of our knowledge is the first description of this in C. perfringens sepsis. We have already reported similar findings in three other patients 23 with septic shock.…”