Left ventricular dysfunction and reversible pulmonary hypertension secondary to severe pneumonia in a background of sepsis: a case report and review of the literature

Pneumonia is a well-recognized respiratory infection associated with substantial morbidity and mortality. Despite its effects on the respiratory system, pneumonia can cause or exacerbate cardiovascular complications through various mechanisms. The two main mechanisms that are described in this case report are hypoxia-induced pulmonary hypertension and the effect of sepsis on the cardiovascular system. Pulmonary hypertension (PH) is a disease characterized by raised pulmonary arterial pressure due to a progressive increase in pulmonary vascular resistance, inevitably leading to right ventricular (RV) afterload. For our case, the situation was complicated by sepsis, which further worsened the myocardial function causing left ventricular hypertrophy and left ventricular dysfunction. The main goal of this case report is to highlight the fact that cardiovascular events due to pneumonia are a potential complication even in young patients who are without any comorbidities. We present a case of a 14-year-old patient who presented with symptoms of cough, hemoptysis, fever, chest pain, and dyspnea. After the necessary investigations, he was diagnosed with severe pneumonia, sepsis, moderate PH, and left ventricular dysfunction. The treatment course was focused on stabilizing the patient by oxygen supplementation, treating the underlying cause with the use of antibiotics, and decreasing the already raised arterial pressures through vasodilator therapy. After the patient went through the proper course of treatment, there was a marked improvement in his general condition.Cardiac complications due to pneumonia are potential complications even in relatively young patients who have no noted comorbidities. Clinicians should be aware of these potentially fatal complications of pneumonia and appreciate the significance of this association for timely recognition, diagnosis, and management of these complications.