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Septic cardiomyopathy: a rare and life-threatening complication of small intestinal perforation: A case report

FanJing Wang1, Run Ma, YuanJia Luo

  • 1Department of Cardiovascular Intensive Care Unit, Northeast Yunnan Central Hospital, Zhaotong, Yunnan Province, China.

Medicine
|June 9, 2026
PubMed

Insights

Septic cardiomyopathy, a severe sepsis complication, can mimic heart attacks. Early recognition and multimodal treatment, including source control and hemodynamic support, are crucial for recovery in critical cases.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Sepsis Research

Background:

  • Septic cardiomyopathy (SCM) is a serious, potentially reversible sepsis complication.
  • High mortality is associated with SCM progressing to cardiogenic shock.
  • Distinguishing SCM from acute coronary syndrome in sepsis patients presents a clinical challenge.

Purpose of the Study:

  • To report a case of SCM secondary to small intestinal perforation.
  • To highlight the diagnostic challenges and successful management of life-threatening SCM.
  • To emphasize the importance of early recognition and comprehensive treatment strategies.

Main Methods:

  • A 62-year-old male with small intestinal perforation developed septic and cardiogenic shock postoperatively.
  • Diagnosis involved ST-segment elevation, elevated troponin, and echocardiographic evidence of reduced ejection fraction (38%).
  • Management included surgical source control, vasopressors, intra-aortic balloon pump, CRRT, and levosimendan.

Main Results:

  • Hemodynamic stabilization and significant cardiac function recovery (ejection fraction improved to 65%).
  • Resolution of ST-segment changes and successful weaning from all supportive therapies.
  • Patient discharged in stable condition after treatment for SCM and cardiogenic shock.

Conclusions:

  • SCM can mimic ST-segment elevation myocardial infarction, posing a diagnostic pitfall.
  • Early identification of SCM is critical for appropriate intervention.
  • A multimodal support strategy, including source control, is essential for favorable outcomes in severe SCM.
Abstract

Keywords:
septic cardiomyopathyseptic shocksmall intestinal perforation

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