# Transient Coronary Microvascular Dysfunction in Septic Shock

**Authors:** Samantha Lörstad, Sara Tehrani, Christina Ekenbäck, Kambiz Shahgaldi, Per Åstrand, Johannes Aspberg, Jonas Persson

PMC · DOI: 10.1016/j.jaccas.2025.103611 · JACC Case Reports · 2025-06-11

## TL;DR

This paper reports a case of sepsis-induced temporary coronary microvascular dysfunction that improved during recovery, despite normal heart function.

## Contribution

The paper presents a novel case study showing transient coronary microvascular dysfunction in sepsis using invasive assessment.

## Key findings

- Coronary microvascular dysfunction occurred in a sepsis patient with preserved heart ejection fraction.
- The dysfunction resolved during recovery from septic shock.
- Acute inflammation may cause long-term vascular changes even after microvascular function appears to recover.

## Abstract

Sepsis is a dysregulated hyperinflammatory response to infection that leads to widespread endothelial damage with impaired microcirculation and organ perfusion. The extent of coronary microvascular dysfunction in sepsis remains largely unexplored.

We present a case of pneumococcal pneumonia complicated by septic shock, where coronary microvascular function was invasively assessed using the thermodilution technique. We observed transient dysfunction in the coronary microcirculation during the transition from the acute to recovery phases of septic shock.

This transient dysfunction does not necessarily signify full coronary microvascular recovery because acute inflammation may lead to long-term changes in vascular structure. This case provides novel insights into cardiac microvascular involvement in sepsis and highlights the importance of further research on its impact on patient outcomes.

Sepsis can cause coronary microvascular dysfunction, even with preserved left ventricular ejection fraction. Sepsis-induced coronary microvascular dysfunction can resolve during the recovery phase.

## Linked entities

- **Diseases:** pneumococcal pneumonia (MONDO:0005972)

## Full-text entities

- **Diseases:** Sepsis (MESH:D018805), Septic Shock (MESH:D012772), pneumococcal pneumonia (MESH:D011018), inflammation (MESH:D007249), Coronary Microvascular Dysfunction (MESH:D003327), infection (MESH:D007239)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12237708/full.md

## References

10 references — full list in the complete paper: https://tomesphere.com/paper/PMC12237708/full.md

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Source: https://tomesphere.com/paper/PMC12237708