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THE HEALTH | OCTOBER , 2022
| Column |
SEPSIS ALERT
BY ASSOC PROF DR TAN TOH LEONG
AND DR JAY REUBEN SAVARIMUTHU
SEPSIS is a medical emergency . One of the feared complications of sepsis is heart failure . If a patient with sepsis develops heart failure and does not receive treatment in a timely manner , the outcome can be devastating . According to an article published in the Journal of American Heart Association in 2018 , sepsis accounts for one quarter of deaths due to heart failure .
Sepsis can cause heart failure in patients with no pre-existing heart condition and can worsen heart function in patients with heart disease or heart failure .
There are various ways sepsis can cause heart failure . Sepsis can also affect various structures of the heart such as : i . Trigger a heart attack . A blockage of the blood flow to the heart can be
Sepsis with heart failure : A medical emergency
If a patient with sepsis develops heart failure and does not receive timely treatment , the outcome can be devastating
seen in sepsis patients . Sepsis can cause inflammation of the blood vessel to the heart , resulting in a heart attack . ii . Inflammation to the layers of the heart can affect the heart ’ s pumping ability and patients can progress rapidly to heart failure . iii . Valves of the heart can be damaged and cause ineffective blood flow to the rest of the body . iv . Rhythm of your heart can be disturbed and caused a condition called Atrial Fibrillation . Patients with heart failure often have Sepsis Induced Cardiomyopathy ( SIC ). It is a type of heart disease and is one of the main predictors of death in sepsis with a mortality rate of 70 per cent . If treatment is given early , these changes can be reversed within seven to 10 days . However , treatment can be very challenging in patients who have developed SIC .
Detecting heart failure
There are symptoms that can indicate if you have heart disease in sepsis . If you experience chest pain , difficulty in breathing , sweat profusely or have
Assoc Prof Dr Tan Toh Leong is Senior Lecturer and Emergency Medical Consultant , UKM Medical Center , Universiti Kebangsaan Malaysia and President and Founder of Malaysian Sepsis Alliance ( MSA ) while Dr Jay Reuben Savarimuthu is Emergency Physician , Emergency & Trauma Department , Hospital Sultanah Nora Ismail , Batu Pahat , Johor , and a member of MSA . palpitations ( awareness of ones ’ heartbeat ), please seek immediate treatment .
There are various ways a doctor can diagnosed SIC or heart failure in their practice .
A common bedside tool that is used is ECG ( Electrocardiography ). If you develop a heart attack or having an abnormal heart rhythm due to sepsis , an ECG would be able to detect it .
A very specific blood investigation for the heart called troponin can be obtained from the patient . If the troponin level is above the cut off value , the patient could be having a heart attack . The BNP ( brain natriuretic peptide ) level can be raised in your blood if you heart is under stress due to sepsis .
A more detailed approach using technology can be adopted at the hospital . An echocardiography can see all the four chambers of the heart and assess heart function .
Doctors will be able to know if your heart is pumping effectively or if the chambers of the heart are enlarged . By having this information , specific drugs can be given to optimise a patient ’ s heart function .
“ A one size fits all ” approach can ’ t be used for all patients in sepsis with heart failure . Research is still ongoing on the various treatment for heart failure . A strategy called cardioprotective strategy that suppress the heart function can be adopted in certain cases . However , this treatment remains controversial till today .
If your loved ones are having an infection , ask yourself this question . Could it be sepsis ? This could save their life . – The Health