2024, Number 2
Cardiovasc Metab Sci 2024; 35 (2)
Double cardiac stress in the postpartum period. Case report of sepsis-induced cardiomyopathy complicated by acute pulmonary embolism
Estrada-Méndez, Andrea; Alducín-Téllez, César René; Gómez-Alayola, Domingo José; Collí-Heredia, Juan Pablo; Gómez-Cruz, Andrea Paola
ABSTRACT
Sepsis-induced cardiomyopathy is a clinical entity rarely reported in the literature. It lacked an objective and agreed-upon definition, and although there are clinical criteria, there are no diagnostic guidelines or specific treatment; its identification, approach, and management imply a challenge for the clinician. Its presence increases mortality by up to 70%. It is considered an acute onset complication that manifests with alterations in systolic and diastolic function, finally showing reversibility in a period of seven to ten days. When this entity is suspected, the gold standard for diagnosis is the echocardiogram. Infection control, life support, and hemodynamic measures associated with the use of vasopressors and inotropes are the main therapeutic tools that have shown a decrease in mortality. However, this entity usually requires advanced organic support, even requiring ventricular assistance devices such as an intra-aortic balloon pump (IABP) or extra corporeal membrane oxygenation (ECMO), which have shown promising results in the treatment of this pathology. Despite this, mortality is high, and the prognosis continues to be unfavorable without early identification, hence the importance of unifying criteria, establishing risk factors, validated diagnostic tools as well as differentiating it from other clinical entities, thereby improving its outcome and prognosis.