Document Detail


Escherichia coli septic shock masquerading as ST-segment elevation myocardial infarction.
MedLine Citation:
PMID:  19332967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elevated cardiac biomarkers in conjunction with electrocardiographic (ECG) changes are valuable in diagnosing acute coronary syndrome (ACS). Elevated troponin I (TnI), while commonly seen in ACS, can also occur in entities such as sepsis and pulmonary thromboembolic disease. Raised TnI levels in patients with sepsis result from various mechanisms, including hypoperfusion or direct extension of infection to cardiac tissue, and can also serve as an important prognostic indicator. Electrocardiographic changes in sepsis are not as well described. Some of the ECG findings associated with septic shock include loss of QRS amplitude, increase in QTc interval, bundle branch blocks, and development of narrowed QRS intervals with deformed, positively deflected J waves (commonly known as Osborn waves). ST-segment elevations in sepsis are rare and have only previously been noted in a handful of case reports involving patients with septic shock. We present a case of a 59-year-old woman with ST-segment elevations and increased levels of cardiac troponin from Escherichia coli septic shock in the setting of normal coronary angiography.
Authors:
Juan D Martinez; Rajesh V Babu; Gulshan Sharma
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Postgraduate medicine     Volume:  121     ISSN:  1941-9260     ISO Abbreviation:  Postgrad Med     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401147     Medline TA:  Postgrad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Allergy, Pulmonary, Immunology, Critical Care and Sleep, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555-0561, USA.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Coronary Angiography
Diagnosis, Differential
Electrocardiography*
Escherichia coli Infections / complications,  diagnosis*
Female
Humans
Middle Aged
Myocardial Infarction / diagnosis*
Shock, Septic / complications,  diagnosis*
Troponin I / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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