Abstract
The patient was a 31-year-old man in whom toxic shock syndrome was suspected based on refractory hypotension and oliguria. Polymyxin B immobilized fiber column direct hemoperfusion was performed. Approximately 2 hours after initiating this treatment, ST-segment elevation and chest pain suddenly occurred, and elevation of myocardial markers was also observed. However, echocardiography revealed no clear regional wall motion abnormalities, and coronary angiography did not show significant stenosis. Subsequently, the electrocardiographic changes diminished and then normalized. His general condition also improved. The patient was discharged in good condition after 10 days of treatment. The mechanisms underlying ST-segment elevation and chest pain may include coronary microcirculation failure and septic cardiac dysfunction due to eicosanoid produced by a staphylococcal exotoxin.
