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Stunned Myocardium in the Toxic Shock Syndrome

Jennie R. Crews, MD; J. Kevin Harrison, MD; G. Ralph Corey, MD; Charles Steenbergen, MD, PhD; and Thomas M. Bashore, MD
[+] Article and Author Information

Requests for Reprints: J. Kevin Harrison, MD, Box 3331, Duke University Medical Center, Durham, NC 27710.

Current Author Addresses: Dr. Crews: Box 31108, Duke University Medical Center, Durham, NC 27710.

Dr. Harrison: Box 3331, Duke University Medical Center, Durham, NC 27710.

Dr. Corey: Box 3038, Duke University Medical Center, Durham, NC 27710.

Dr. Steenbergen: Box 3712, Duke University Medical Center, Durham, NC 27710.

Dr. Bashore: Box 3012, Duke University Medical Center, Durham, NC 27710.


Ann Intern Med. 1992;117(11):912-913. doi:10.7326/0003-4819-117-11-912
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Although it is not commonly recognized, myocardial dysfunction in the toxic shock syndrome may be severe, even life-threatening (1, 2). The cause of this acute cardiomyopathy remains unclear. Clinically, left ventricular dysfunction in the toxic shock syndrome has been reversible, similar to prolonged but transient postischemic myocardial dysfunction, a process termed "stunned myocardium" (3). Cardiac histopathologic findings in the toxic shock syndrome are limited to autopsy data, and the pathologic changes seen have been modest compared with the clinical severity of left ventricular dysfunction (4, 5). We report the first premortem cardiac histologic findings in a patient with severe, acute

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