EDWARD B. ROTHERAM JR., M.D.
To the editor: Parker and associates (1) show that survivors of septic shock had initially increased left ventricular dimensions that fell dramatically to normal size during recovery. Paradoxically, nonsurvivors did not have left ventricular dilatation, even shortly before their deaths. The authors postulate that edema may have reduced myocardial compliance in the nonsurvivors.
Another possibility is that their right, rather than left, ventricles dilated. If both ventricles became linked through pericardial constraint, the decreased compliance of the left ventricle would be explained (2). The hemodynamic situation would resemble a clinically evident right ventricular infarction. Some animals regularly respond to endotoxin
ROTHERAM EB. Septic Shock and Right Ventricular Function. Ann Intern Med. ;101:150. doi: 10.7326/0003-4819-101-1-150_1
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Published: Ann Intern Med. 1984;101(1):150.
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