Cardiomyopathy of sepsis has been described over three decades ago while
sporadic description of the phenotype has permeated the literature for two decades prior
to the emergence of a coherent description. Although its prevalence is high in severe
sepsis and septic shock, its impact on the overall prognosis of patients with sepsis is
less clear. The clinical manifestations are varied and the syndrome presents several
phenotypes, depending on when observations are made and how severe the underlying
sepsis is. The most important concepts underlying the current understanding of the
cellular pathophysiology, namely inflammation-driven elevations on various forms of
intracellular nitric oxide synthases, their interaction with calcium fluxes, cellular
respiration and oxidative stress are reviewed. The links between current concepts of
pathophysiology, clinical manifestations and therapeutic options are discussed.
Keywords: Calcium channels, Cardiomyopathy, Dobutamine, Echocardiography, Fluid
responsiveness, Levosimendan, Muscle contraction, Nitric oxide, Pulmonary
hypertension, Sepsis, Septic shock, Troponin, Ventricular dysfunction.
