When sepsis affects the heart: A case report and literature review

作     者：Giuseppe Clemente Antonino Tuttolomondo Daniela Colomba Rosaria Pecoraro Chiara Renda Vittoriano Della Corte Carlo Maida Irene Simonetta Antonio Pinto 

作者机构：U.O.C.di Medicina Interna e Cardioangiologia University of Palermo 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2015年第3卷第8期

页      面：743-750页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Sepsis Shock Hypotension Troponin Myocardial dysfunction 

摘      要：A 59-year-old nursing home patient with Down syndrome was brought to the internal medicine department of our hospital due to fever, cough without expectorate, and dyspnea. A thoracic computed tomography revealed the presence of bilateral basal parenchymal opacities. Her condition deteriorated after admission and troponin reached a peak serum concentration of 16.9 ng/m L. The patient was in cardiogenic shock. In addition to fluid resuscitation, vaso-active amine infusion was administered to achieve hemodynamic stabilization. The differential diagnosis investigated possible pulmonary embolism, myocardial infarction, and myocarditis. Furthermore, a second transthoracic echocardiogram suggested Tako-Tsubo syndrome. This is a septic patient. The purpose of this manuscript is to review studies which formerly examined the possible association between high levels of troponin and mortality to see if it can be considered a positive predictive factor of fatal prognosis as the case of thrombocytopenia, already a positive independent predictive factor of multiple organ failure syndrome, and generally to characterize risk profile in a septic patient.