Case report: Escherichia coli septic shock masquerading as ST-segment elevation myocardial infarction

Juan D. Martinez, Rajesh V. Babu, Gulshan Sharma

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)102-105
Number of pages4
JournalPostgraduate medicine
Volume121
Issue number2
DOIs
StatePublished - Mar 1 2009

Keywords

  • Cardiac enzymes
  • ECG
  • Myocardial infarction
  • ST-segment elevation
  • Septic shock
  • Troponin

ASJC Scopus subject areas

  • Medicine(all)

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