Septic Cardiomyopathy: A Case Series from a Tertiary Care Center

Abstract Sepsis is a life-threatening condition characterized by a dysregulated host response to infection, often leading to multiorgan dysfunction. Septic cardiomyopathy (SCM) is an increasingly recognized but underdiagnosed complication, defined by reversible, nonischemic myocardial dysfunction with reduced left ventricular ejection fraction and global hypokinesia. This case series describes six adult patients admitted to a tertiary care ICU with sepsis or septic shock who developed SCM. Diagnosis was established using intensivist-performed point-of-care ultrasound (POCUS), demonstrating new-onset left ventricular systolic dysfunction in the absence of significant coronary artery disease. The etiologies included infected pancreatic necrosis, postoperative sepsis, invasive fungal pneumonia, VAP, and CRBSI. All patients exhibited reduced ejection fraction ranging from 15% to 35%, with one case demonstrating a Takotsubo-like pattern. Management involved culture-directed antimicrobial therapy, inotropes (dobutamine / levosimendan), vasopressors, and organ support. Five patients showed complete recovery of cardiac function within 5–7 days, while one patient succumbed to refractory septic shock. POCUS played a pivotal role in early diagnosis, exclusion of alternative causes of shock, and guiding individualized hemodynamic management in all cases. This series highlights SCM as a frequent yet reversible manifestation of septic shock and underscores the importance of early bedside POCUS in improving diagnostic accuracy and optimizing patient outcomes.