Sepsis and Myocardial Depression in a Young Woman

Subla, Mir Rauf; Khan, Shakila; Behl, Deepti; Peters, Steve G.

doi:10.1016/s0025-6196(11)61537-1

Cited by 10 publications

(10 citation statements)

References 41 publications

(29 reference statements)

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“…15 Sepsis-induced myocardial depression (SIMD) in people is primarily a clinical diagnosis and relies upon transthoracic echocardiography. 16 Classic echocardiographic evidence of SIMD includes biventricular dilatation and reduced ejection fraction associated with a clinical syndrome of sepsis. 16 Recovery tends to parallel recovery from sepsis, with recovery within 7-10 days.…”

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confidence: 99%

“…16 Classic echocardiographic evidence of SIMD includes biventricular dilatation and reduced ejection fraction associated with a clinical syndrome of sepsis. 16 Recovery tends to parallel recovery from sepsis, with recovery within 7-10 days. 8 Prognosis in people is often dependent upon the primary septic insult; in fact, many patients with severe myocardial depression survive.…”

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confidence: 99%

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Reversible Myocardial Depression Associated with Sepsis in a Dog

Dickinson¹,

Rozanski²

2007

J Vet Int Med

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A 5-month-old, 22-kg intact female Rhodesian Ridgeback was examined at the Tufts Cummings School of Veterinary Medicine Foster Hospital for Small Animals for progressive hind limb pain, fever, lethargy, and anorexia of 3-days duration. The dog had been examined for pain and prescribed meloxicam at an unknown dose on initial visit to the referring veterinarian, but the clinical signs and fever worsened. The local emergency clinic performed 2 examinations over the following days as the condition progressed. The dog had been previously healthy with no significant medical history before the acute onset of clinical signs.The dog was referred for further evaluation, and on presentation was quiet but responsive, febrile (103.5uF), with a heart rate at 120 beats per minute and high respiratory rate at 36 breaths per minute. A loud S3 gallop was auscultated, but no audible murmurs or arrhythmias were present. The jugular vein observation was normal. Femoral arterial pulses were judged to be weak. Multiple joint effusions were present, with distension and edema observed particularly over the left stifle and tarsus and marked edema to the entire left distal pelvic limb. The right and left carpi and the right stifle and tarsus were also slightly swollen. The neurologic examination findings were normal, although the dog was unwilling to walk. Oral examination documented pale mucous membrane color and evidence of lost deciduous and newly erupting permanent teeth. The joint fluid was purulent, and numerous degenerative neutrophils with intracellular bacteria were visualized on cytologic examination.There was a white blood count of 14,600/mL (reference range, 4,900-16,900/ ml) with 9,336 mature neutrophils/mL, a left shift (band neutrophils, 584 mL; reference range, 0-300/uL) and a monocytosis (3,358 mL; reference range, 100-1,500mL). The neutrophils were moderately to markedly toxic. Platelet count was low at 56,000/mL (reference range, 181-525,000/mL). Hyponatremia (141 mEq/L; reference range, 142-158 mEq/L), hypochloremia (105 mEq/L; reference range, 106-126 mEq/L), increase in total bilirubin (2.40 mg/dL; reference range, 0.1-0.3 mg/dL), increase in alkaline phosphatase (1,691 U/L; reference range, 12-121 U/L), increase in alanine aminotransferase activity (1,344 U/L; reference range, 18-86 U/L), and increase in aspartate aminotransferase activity (928 U/L; reference range, 16-54 U/L) were present. The serum was icteric. Urinalysis results indicated concentrated urine (specific gravity, 1.050) with the presence of heme, bilirubin, and protein (100 mg/dL). Bilirubin crystals were visible in the sediment.Culture of the tarsal joint fluid yielded Pasteurella multocida (4+ growth), whereas the aerobic and anaerobic blood cultures obtained on the day of admission were positive for P multocida and Peptostreptococcus spp., respectively. There are no National Committee of Clinical Laboratory Standards for susceptibility testing for P multocida, but rather ampicillin/penicillin, potentiated amoxicillin, tetracycline, trimethoprim/su...

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confidence: 99%

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confidence: 99%

Reversible Myocardial Depression Associated with Sepsis in a Dog

Dickinson¹,

Rozanski²

2007

J Vet Int Med

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“…10 An alternative cardiovascular syndrome that can present in a similar fashion to our patient, but without overt evidence for myocarditis, is a transient cardiomyopathy associated with bacterial sepsis, a syndrome not unique to infection with S. pneumoniae. 11,12 A recent article identified 20 patients admitted to the intensive care unit with sepsis, septic shock, or the systemic inflammatory response syndrome and compared them with ageand sex-matched intensive care unit controls without sepsis syndromes. 11 Seven of the case patients had pneumococcal infections, four with pneumonia and three with meningitis.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, a recent case report described a 21-year-old woman with an eating disorder who presented with pneumococcal pneumonia and sepsis associated with severe biventricular systolic dysfunction (left ventricular ejection fraction 15%-20%) without an elevation in cardiac enzymes. 12 Her cardiomyopathy reversed within 72 hours with the administration of antibiotics, human activated protein C, and supportive care. 12 The absence of cardiac enzyme elevation suggests that she had a sepsis-induced cardiomyopathy that differed from our patient's episode, although the two clinical cases might represent a continuum of the same disorder.…”

Section: Discussionmentioning

confidence: 99%

“…12 Her cardiomyopathy reversed within 72 hours with the administration of antibiotics, human activated protein C, and supportive care. 12 The absence of cardiac enzyme elevation suggests that she had a sepsis-induced cardiomyopathy that differed from our patient's episode, although the two clinical cases might represent a continuum of the same disorder. The peak troponin in our case was 44.5 ng/mL, versus a range of .18 to 1.38 ng/mL for the patients with pneumococcal infection in the aforementioned series of intensive care patients.…”

Section: Discussionmentioning

confidence: 99%

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Severe transient cardiomyopathy associated with community-acquired pneumonia caused by Streptococcus pneumoniae

Gandhi

Aronoff

2008

Heart & Lung

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Transesophageal echocardiography combined with ProAQT/PulsioFlex hemodynamic monitoring in anesthetic management of a patient with septic shock associated with septic cardiomyopathy: A case report

Gu,

Yang

2023

Clinical Case Reports

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Key Clinical MessagePatients with septic shock complicated by septic cardiomyopathy (SCM) can be extremely ill and at high risk for mortality. If early assessment of cardiac function is neglected during treatment, sepsis may be further exacerbated. We report a 77‐year‐old male patient with severe septic shock who underwent intraoperative transesophageal echocardiography (TEE) because of progressive circulatory instability, SCM was diagnosed. Further perioperative treatment to support the circulation was successfully adjusted based on TEE and pulse index continuous cardiac output (CO) by ProAQT/PulsioFlex hemodynamic monitoring. We should consider a diagnosis of SCM in the perioperative period and perform ultrasonography routinely. The use of TEE with ProAQT/PulsioFlex offers a new option for anesthetic management.

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Sepsis and Myocardial Depression in a Young Woman

Cited by 10 publications

References 41 publications

Reversible Myocardial Depression Associated with Sepsis in a Dog

Reversible Myocardial Depression Associated with Sepsis in a Dog

Severe transient cardiomyopathy associated with community-acquired pneumonia caused by Streptococcus pneumoniae

Transesophageal echocardiography combined with ProAQT/PulsioFlex hemodynamic monitoring in anesthetic management of a patient with septic shock associated with septic cardiomyopathy: A case report

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