Fig. 1

Septic shock at its onset, in hospital-acquired pneumonia, 3rd postoperative month of double lung transplant. Patient intubated and mechanically ventilated. SAP 85/40 mmHg, HR 160 bpm, with signs of inadequate tissue perfusion. TTE subcostal 4-chamber view (upper panels, Video 1A ESM) and parasternal short axis midpapillary view (middle panels, Video 1B ESM) show a hyperkinetic pattern, with marked reduction of LV and RV size from end-diastole (a, c) to end-systole (b, d). Inferior vena cava (subcostal IVC view, lower panels) is small (e) and shows significant increase in size with mechanical passive inspiration (f). RA right atrium, RV right ventricle, LA left atrium, LV left ventricle, IVC inferior vena cava