Cardiac depression, also known as myocardial depression, is one of the typical complications of severe acute pancreatitis. The review describes modern views on the mechanism of development of this phenomenon; the place of the term myocardial depression factor at the current stage of study of the problem was discussed; pathogenetic factors of myocardial depression requiring further study have been identified. An attempt to consider cardiac depression as a phenomenon involving the whole cardiovascular system, rather than the heart along, was made. Each pathophysiological factor is examined in terms of the possibility of clinical use.