THE HEALTH | AUGUST , 2023

SEPSIS ALERT

BY ASSOC PROF DR TAN TOH LEONG

AND DR JAY REUBEN SAVARIMUTHU

While sepsis is often associated with infections in various parts of the body , its impact on the heart is a silent threat that demands attention .

The heart , a vital organ responsible for pumping blood and delivering oxygen and nutrients throughout the body , is highly susceptible to the damaging effects of sepsis . When the body encounters an infection , the immune system triggers a cascade of events to fight off the invading pathogens . However , in sepsis , this immune response becomes dysregulated , leading to an overwhelming inflammatory response that can negatively impact the heart . One of the primary ways sepsis affects the heart is through a condition called septic cardiomyopathy . Cardiomyopathy refers to a weakened and enlarged heart muscle , which can lead to impaired heart function .

During sepsis , the heart muscle becomes inflamed and weakened , compromising its ability to pump blood effectively . This can result in reduced blood flow to vital organs , including the brain , kidneys , and liver , leading to organ failure if left untreated .

MECHANISMS UNDERLYING SEPTIC CARDIOMYOPATHY ARE COMPLEX

Furthermore , sepsis-induced cardiomyopathy can disrupt the electrical signals that regulate the heart ’ s rhythm , leading to arrhythmias . Irregular heart rhythms can be dangerous , as they may result in a rapid or erratic heartbeat , which can be life-threatening .

Additionally , the compromised heart muscle may struggle to meet the body ’ s demand for oxygen , leading to a condition known as myocardial

ischemia . Inadequate blood flow to the heart muscle can cause chest pain , known as angina , and in severe cases , it can result in a heart attack .

The mechanisms underlying septic cardiomyopathy are complex and not yet fully understood . However , several factors contribute to its development . The release of pro-inflammatory cytokines and other immune mediators during sepsis plays a crucial role in triggering inflammation and damaging the heart tissue . Additionally , the presence of bacterial toxins and the formation of blood clots within the blood vessels can

Assoc Prof Dr Tan Toh Leong is Senior Lecturer and Emergency Medical Consultant , UKM Medical Center , Universiti Kebangsaan Malaysia ( UKM ) and President and Founder of Malaysian Sepsis Alliance ( MySepsis ), while Dr Jay Reuben Savarimuthu is Emergency Physician , Emergency & Trauma Department , Hospital Sultanah Nora Ismail , Batu Pahat , Johor and member of MySepsis . further impair blood flow to the heart , exacerbating the cardiac damage . Recognising the signs and symptoms of sepsis-related heart complications is important to ensure early detection and prompt treatment . Patients with septic cardiomyopathy may experience symptoms such as shortness of breath , rapid or irregular heartbeat , chest pain , heart failure signs , swollen ankles and fatigue .

MITIGATING THE DETRIMENTAL EFFECTS

Timely intervention and management are crucial in preventing further deterioration of heart function and improving patient outcomes . Increasing public awareness about sepsis and its potential impact on heart health is vital . Educating individuals about the signs and symptoms of sepsis-related cardiac complications can empower them to seek immediate medical attention when necessary .

Moreover , healthcare providers must be equipped with the knowledge and tools to identify sepsis early and implement appropriate interventions promptly . Timely administration of antibiotics and fluid resuscitation , along with close monitoring of heart function , can help mitigate the detrimental effects of sepsis on the heart .

In conclusion , sepsis presents a silent threat to the heart , potentially leading to severe complications such as cardiomyopathy , arrhythmias , and myocardial ischemia . Raising awareness about the connection between sepsis and heart health , educating the public and healthcare professionals , and investing in research to develop targeted treatments are all essential steps in addressing this significant health concern .

By shedding light on the silent threat of sepsis to the heart , we can work towards better understanding , preventing , and managing this lifethreatening condition . – The Health