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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Hypertension Sepsis, Troponin, Demand Ischemia Due To Sepsis Mean?

My husband was transferred from the ICU rehap hosp to the main hosp ER for hypoxia, hypercarbia, hypertension, suspecting from sepsis and chest pain with very slightly elevation of troponin, most likely related to demand ischemia due to sepsis, needing to evaluate for acute coronary artery syndrome & shock. What is the meaning for hypertension sepsis, troponin, demand ischemia due to sepsis and then leading to acute coronary artery syndrome & shock?
Wed, 1 Apr 2015
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Cardiologist 's  Response
Hello! Thank you for asking on HCM! Regarding your concern I would like to explain that sepsis is only one step to a broad spectrum of body distress; ranging from high-energy consuming demands to multi-organs dysfunction and failure, and to the final high-lethal state of septic shock. So at the beginning is present a hyperdynamic dynamic state; and possibly hypertension. After that, as micro-circulatory and cellular dysfunction follow (as the result of the microbiological and toxins effects), appears tissue ischemia throughout the body, comprising even myocardial ischemia (even in the presence of insignificant coronary lesions, or in their absence). This mechanism explains demand ischemia. Metabolism turns highly to an anaerobic one, and tissue injury markers appear in the blood (one of them is troponin, etc). When this vicious cycle is not interrupted during early stage, this is a lethal disorder. Frequently it is found septic shock heart pattern (with diffuse and patchy lesions in the absence of distinct coronary lesions).
Hope to have answered your question.
I wish a fast recovery to your husband! Greetings! Dr. Iliri
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What Does Hypertension Sepsis, Troponin, Demand Ischemia Due To Sepsis Mean?

Hello! Thank you for asking on HCM! Regarding your concern I would like to explain that sepsis is only one step to a broad spectrum of body distress; ranging from high-energy consuming demands to multi-organs dysfunction and failure, and to the final high-lethal state of septic shock. So at the beginning is present a hyperdynamic dynamic state; and possibly hypertension. After that, as micro-circulatory and cellular dysfunction follow (as the result of the microbiological and toxins effects), appears tissue ischemia throughout the body, comprising even myocardial ischemia (even in the presence of insignificant coronary lesions, or in their absence). This mechanism explains demand ischemia. Metabolism turns highly to an anaerobic one, and tissue injury markers appear in the blood (one of them is troponin, etc). When this vicious cycle is not interrupted during early stage, this is a lethal disorder. Frequently it is found septic shock heart pattern (with diffuse and patchy lesions in the absence of distinct coronary lesions). Hope to have answered your question. I wish a fast recovery to your husband! Greetings! Dr. Iliri