Sepsis-Induced Cardiomyopathy Diagnosis Criteria

Sepsis-induced cardiomyopathy is a serious complication of severe sepsis. When sepsis progresses to a more critical stage and persists over time, it can lead to multi-organ dysfunction, including cardiac involvement, which is referred to as septic cardiomyopathy. The diagnosis of this condition primarily relies on clinical signs of sepsis, supported by symptoms, physical examination findings, biochemical markers, and laboratory tests.

Key Clinical Symptoms of Cardiac Involvement

Cardiac-related symptoms are often the first indicators of myocardial dysfunction in septic patients. These may include tachycardia (rapid heartbeat), palpitations, chest discomfort, or a general feeling of heart distress. In alert patients, these symptoms can be directly reported, aiding in early detection and assessment.

Assessment in Unresponsive Patients

In unconscious or non-communicative patients, subjective symptoms may not be available. In such cases, healthcare providers rely heavily on objective signs such as abnormal readings from electrocardiogram (ECG) monitoring, which may reveal tachycardia or arrhythmias indicative of cardiac impairment.

Biochemical Markers and Laboratory Findings

Elevated Cardiac Enzymes

Elevation of cardiac enzymes, particularly troponin and creatine kinase-MB (CK-MB), is a crucial biochemical indicator of myocardial injury. These levels are typically higher than normal ranges and correlate with the severity of cardiac dysfunction in septic patients.

Imaging and Functional Assessments

Imaging modalities such as echocardiography play a vital role in confirming the diagnosis. An echocardiogram allows clinicians to evaluate both the structure and function of the heart. A key parameter assessed is the ejection fraction (EF), which measures the percentage of blood pumped out of the left ventricle with each heartbeat. A significantly reduced EF, especially when correlated with a history of sepsis, strongly supports the diagnosis of sepsis-induced cardiomyopathy.