Electrocardiographic Changes in Septic Shock

Septic shock is a severe condition characterized by metabolic, cellular, and circulatory alterations associated with high mortality rates. This study aimed to determine the most common electrocardiographic alterations in patients with septic shock and to review their relationship with mortality. This was a prospective, observational, and descriptive study. The study included 37 patients from July to December 2023 at the Adult Continuous Admission Unit of the Infectology Hospital at "Centro Médico Nacional La Raza." Upon admission, all patients underwent 12-lead electrocardiograms (ECG), with follow-up exams performed at 24, 48, and 72 hours. Medical residents and staff cardiologists interpreted the studies. Pneumonia, meningitis, and soft tissue infections were the most frequent admission diagnoses. The predominant electrocardiographic alterations were left ventricular strain (67%), sinus tachycardia (25%), necrosis (6%), and sinus bradycardia (2%). The overall mortality rate was 53%. Left ventricular strain showed a sensitivity of 0.79, a specificity of 0.44, and a case-fatality rate of 60%. These findings suggest that ventricular strain and changes in heart rate may be related to the compensatory hemodynamic response, fluid administration, and the use of vasopressors in septic shock conditions.