All patients admitted to the Intensive Care Unit in the Department of Critical Care Medicine at ESIC Medical College Faridabad will be screened for sepsis in accordance with the Sepsis 3 definition. Screening will occur either at the time of admission or within twenty four hours prior to ICU admission to determine eligibility for the study.

The patients will be retrospectively divided into two groups. The study group will consist of patients diagnosed with septic shock. The control group will include patients with sepsis who did not develop septic shock. Both groups will be matched for age and sex in order to minimize bias and allow accurate comparisons.

Each enrolled patient will undergo a detailed clinical history and physical examination. Baseline clinical data will be recorded, including age, gender, presence of comorbidities, hemodynamic parameters, vasopressor requirements, and severity scores such as the Sequential Organ Failure Assessment score and the Acute Physiology and Chronic Health Evaluation II score. These parameters will be documented on the day of ICU admission.

The probable source of infection will be determined using appropriate culture techniques including analysis of sputum, blood, urine, cerebrospinal fluid, and serous body fluids. All patients will undergo both routine laboratory investigations and specific tests as clinically indicated.

Echocardiographic assessments will be conducted at defined time points. In the study group of patients with septic shock, the first transthoracic echocardiography will be performed within twenty four hours of ICU admission. A second echocardiogram will be conducted seventy two hours after the first, and a third examination will be carried out at the time of clinical recovery, which is defined as the point when all vasopressors and inotropic support have been discontinued.

In the control group of patients with sepsis but without shock, the first transthoracic echocardiography will also be performed within twenty four hours of diagnosis. The second echocardiography will be done seventy two hours later, and the third will be carried out either on the seventh day or at the time of antibiotic deescalation, whichever occurs later.

All echocardiographic examinations will be performed by a single trained and certified cardiologist with expertise in echocardiography. The procedure will be done with the patient in the supine or left lateral position using a three point five megahertz ultrasound transducer. All image data will be recorded and stored in digital cine loop format for further analysis.