Sepsis-induced myocardial dysfunction (SIMD) is a common and reversible complication in severe sepsis and septic shock patients. Its pathogenesis is complex and probably mediated by cytokines. Echocardiography is the gold standard to make the diagnosis of SIMD. Cardiac biomarkers have a high negative predictive value for SIMD. Norepinephrine is the first line vasopressor. Inotropic drugs should be used in the case of left ventricular systolic dysfunction associated with persisting tissular hypoperfusion.