Myocarditis is commonly a diagnosis of exclusion. We report a case of fulminant myocarditis in a patient with cardiogenic shock in whom the initial diagnosis was unclear. Early supportive care including extracorporeal membrane oxygenation and intraaortic balloon pump were instituted. Complete recovery of cardiac function was achieved. This case highlights the difficulty in diagnosing myocarditis and the benefits of early intensive support.
HareJ.M., BaughmanK.L.Fulminant and acute lymhocytic myocarditis: the prognostic value of clinicopathological classification.Eur Heart J2001; 22: 269–270.
3.
DroryY., TuretzY., HissY., LevB, FismanE.Z., PinesA., KramerM.R.Sudden unexpected death in persons less than 40 years of age.Am J Cardiol1991; 68: 1388–1392.
4.
KawaiC.From myocarditis to cardiomyopathy: mechanisms of inflammation and cell death: learning from the past for the future.Circulation1999; 99: 1091–1100.
5.
KearneyM.T., CottonJ.M., RichardsonP.J., ShahA.M.Viral myocarditis and dilated cardiomyopathy: mechanisms, manifestations, and management.Postgrad Med J2001; 77: 4–10.
6.
AretzH.T.Myocarditis: the Dallas criteria.Hum Pathol1987; 18: 619–624.
7.
KatoS., MorimotoS., HiramitsuS., UemuraA., OhtsukiM., KatoY.Risk factors for patients developing a fulminant course with acute myocarditis.Circ J2004; 68: 734–739.
8.
MasonJ.W., O'ConnellJ.B., HerskowitzA., RoseN.R., McmanusB.M., BillinghamM.E.The myocarditis treatment trial investigators. A clinical trial of immunosuppressive therapy for myocarditis.N Engl J Med1995; 333: 269–275.
FrustaciA., ChimentiC., CalabreseF., PieroniM., ThieneG., MaseriA.Immunosuppressive therapy for active lymphocytic myocarditis.Circulation2003; 107: 857–863.
11.
OakleyC.M.Myocarditis, pericarditis and other pericardial diseases.Heart2000; 84: 449–454.
12.
ChenY.S., YuH.Y., HuangS.C., ChiuK.M., LinT.Y., LaiL.P.Experience and result of extracorporeal membrane oxygenation in treating fulminant myocarditis with shock: what mechanical support should be considered first?J Heart Lung Transplant2005; 24: 81–87.
13.
GrindaJ-M, ChevalierP., D'AttellisN., BricourtM-O, BerrebiA., GuibourtP.Fulminant myocarditis in adults and children: bi-ventricular assist devise for recovery.Eur J Cardiothorac Surg2004; 26: 1169–1173.
14.
ChenY.S., WangM.J., ChouN.K., HanY.Y., ChiuI.S., LinF.Y.Rescue for acute myocarditis with shock by extracorporeal membrane oxygenation.Ann Thorac Surg1999; 68: 2220–2224.
15.
AsaumiY., YasudaS., MoriiI., KakuchiH., OtsukaY., KawamuraA.Favourable clinical outcome in patients with cardiogenic shock due to fulminant myocarditis supported by percutaneous extracorporeal membrane oxygenation.Eur Heart J2005; 26: 2185–2192.
16.
McCarthyR.E.3rd, BoehmerJ.P., HrubanR.H., HutchinsG.M., KasperE.K., BaughmanK.L.Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis.N Engl J Med2000; 342: 690–695.
17.
D'AmbrosioA., PattiG., ManzoliA., SinagraG., Di LenardaA., SilvestriF.The fate of acute myocarditis between spontaneous improvement and evolution to dilated cardiomyopathy: a review.Heart2001; 85: 499–504.
