Myocardial function in the systemic inflammatory response syndrome is typically:

• A. Depression
• B. Enhancement
• C. No change
• D. Hyperactivity

Answer: (A)

In SIRS, inflammatory mediators released during the systemic response tend to depress heart muscle function. Cytokines like TNF-alpha and IL-1, along with nitric oxide and disrupted calcium handling, reduce the myocardium’s contractility. This leads to lower systolic function and can produce septic cardiomyopathy, even though the patient may be tachycardic. Importantly, this depression is usually reversible as the inflammatory state settles. So, the typical myocardial response in SIRS is a decline in function, not an increase.