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Background  Indications for using veno‐arterial extracorporeal membrane oxygenation (V‐A ECMO) in sepsis cases remain unclear.    Case Presentation  A 66‐year‐old man with pre‐existing chronic heart failure developed severe pneumonia resulting in refractory septic shock. He was diagnosed with septic cardiomyopathy based on depressed left ventricular ejection fraction and a dilated left ventricle based on a transthoracic echocardiogram. We initiated V‐A ECMO on day 3 because the shock did not respond to conventional therapy. The patient's hemodynamics improved, and his infection was reduced. He recovered fully and was discharged on day 107 with his cardiac function restored to its baseline.    Conclusion  Septic cardiomyopathy is a form of reversible myocardial dysfunction. Veno‐arterial extracorporeal membrane oxygenation should be considered for septic cardiomyopathy with intractable circulatory failure. Pre‐existing chronic heart failure is not a contraindication for VA‐ECMO.

Successful use of veno‐arterial extracorporeal membrane oxygenation for septic cardiomyopathy in a patient with pre‐existing chronic heart failure