A 24-year-old patient with no previous cardiovascular illness or symptoms, was admitted in profound cardiogenic shock related to severe left ventricular systolic dysfunction, accompanied by multiple sclerosis (MS) exacerbation. Initially the patient required mechanical ventilation, inotropic support, and intra-aortic balloon counter-pulsation along with invasive haemodynamic monitoring. Within a few days of high dose corticosteroid therapy patients left ventricular systolic dysfunction returned almost completely to normal, and this was accompanied by dramatic clinical improvement. We review the current literature on the relation between MS and left ventricular systolic dysfunction and heart failure.