Mechanical Circulatory Supports in the Treatment of Fulminant Myocarditis

Abstract

Background and Objectives：Although fulminant myocarditis (FM) is known as a fatal disease, once patients have recovered, with aggressive pharmacologic therapy and/or mechanical circulatory supports (MCS), including intra-aortic pump, temporary ventricular assist device and percutaneous cardiopulmonary support, they may return to normal life with an excellent long-term prognosis. Elevated C-reactive protein, Creatinine phosphokinase and cytokine concentrations, decreased left ventricular ejection fraction and intraventricular conduction disturbances on admission may predict the progress of acute myocarditis to fulminant course. Early MCS helps save life and prevent multi-organ failures in patients with FM. The type of MCS may not affect the outcome of the clinical course when its complications are managed properly. Since other managements with immunoglobulin, antiviral agent or monoclonal antibody remain to be confirmed, aggressive hemodynamic support with MCS is the best management for patients with FM, who once recovered from the acute phase can return to normal life. (Korean Circulation J 2005;35:563-572) KEY WORDS：Myocarditis；Prognosis；Mechanical circulatory supports.

Myopericarditis in a Korean Young Male With Systemic Lupus Erythematosus

“… 5) Early mechanical circulatory supports help to save the life and prevent multi-organ failures in patients with fulminant myocarditis. 12) …”

Mechanical Circulatory Support to Control Medically Intractable Arrhythmias in Pediatric Patients After Cardiac Surgery

“…ECMO has traditionally been utilized for preoperative, intraoperative or postoperative cardiac failure, and cardiomyopathies. 14) 15) More recently, the indications for ECMO have expanded to patients with acute cardiovascular decompression including intractable arrhythmias. 16) 17) In these cases, MCS was used to give the heart a period of rest and decompression, until the arrhythmia could be controlled.…”

Giant Cell Myocarditis Manifested as Fulminant Myocarditis

“…Although there are only case reports of acute viral myocarditis in Korea 3)4) and a few recent reports clearly saying that FM is associated with coxsackievirus type B3(CVB3), 5) and adenovirus, 6) the causative virus of FM has not been well clarified.…”