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Case Report Volume 18 Issue 4
Sepsis-induced myocardial dysfunction: a global overview of a common disorder. case reports and a narrative review of the literature
Ervin Manzo Palacios MD, Paloma Elizabeth Sandoval Chavez, Estephania Reyes Botello, Jose Ernesto Salamanca González, Erick Jovary Gómez Cruz, Oscar Edson Miramontes Jaramillo
Received: July 13, 2026 | Published: July 30, 2026
Citation: Manzo PE, Chavez PES, Botello ER, et al. Sepsis-induced myocardial dysfunction: a global overview of a common disorder. case reports and a narrative review of the literature. J Anesth Crit Care Open Acce. 2026;18(3):74-83. DOI: 10.15406/jaccoa.2026.18.00656
Abstract
Sepsis-induced myocardial dysfunction (SIMD), often referred to as septic cardiomyopathy (SCM), is a frequent yet under-recognized complication of sepsis and septic shock, reported in 10–70% of critically ill patients and consistently associated with higher mortality. Despite having been described almost six decades ago, the condition still lacks a unified definition, validated diagnostic thresholds, and a disease-specific treatment. It is characterized by acute, generally reversible biventricular systolic and/or diastolic impairment that occurs in the absence of obstructive coronary disease and typically recovers within seven to ten days. We present three illustrative cases managed in our intensive care unit—a streptococcal toxic shock syndrome complicating Fournier gangrene, a biliary sepsis mimicking acute coronary syndrome, and a refractory septic shock requiring venoarterial extracorporeal membrane oxygenation—and review the current understanding of the epidemiology, pathophysiology, multimodal diagnosis, and therapeutic strategies for SIMD. Early recognition through bedside echocardiography and cardiac biomarkers, source control, individualized hemodynamic support, and management of multiorgan dysfunction remain the cornerstones of care
Keywords: septic cardiomyopathy; sepsis-induced myocardial dysfunction; septic shock; echocardiography; methylene blue; vasoplegia; critical care
©2026 Manzo, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.
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