Pathological Substratum for a Case of Fulminant Myocarditis Treated with Extracorporeal Membrane Oxygenation and Subsequent Heart Transplantation

Fulminant myocarditis has been defined as the clinical manifestation of cardiac inflammation with rapid-onset heart failure and cardiogenic shock. We report on the case of a 23-yr-old woman with pathology-proven fulminant lymphocytic myocarditis presenting shock with elevated cardiac troponin I and...

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Bibliographic Details
Published in:Journal of Korean medical science 2015, 30(9), 204, pp.1367-1372
Main Authors: Kim, In Ae, Yang, Hyun Suk, Kim, Wan Seop, Chee, Hyun Keun
Format: Article
Language:English
Subjects:
Case Report
Combined Modality Therapy - methods
Extracorporeal Membrane Oxygenation - methods
Female
Heart Transplantation
Humans
Myocarditis - complications
Myocarditis - diagnosis
Myocarditis - therapy
Shock - diagnosis
Shock - etiology
Shock - prevention & control
Treatment Outcome
Young Adult
의학일반
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Summary:Fulminant myocarditis has been defined as the clinical manifestation of cardiac inflammation with rapid-onset heart failure and cardiogenic shock. We report on the case of a 23-yr-old woman with pathology-proven fulminant lymphocytic myocarditis presenting shock with elevated cardiac troponin I and ST segments in V1-2, following sustained ventricular tachycardia and a complete atrioventricular block. About 55 min of intensive cardio-pulmonary resuscitation, with extracorporeal membrane oxygenation support, bridged the patient to orthotopic heart transplantation. The explanted heart revealed diffuse lymphocytic infiltration and myocyte necrosis in all four cardiac chamber walls. Aggressive mechanical circulatory support may be an essential bridge for recovery or even transplantation in patients with fulminant myocarditis with shock.
ISSN:1011-8934
1598-6357
DOI:10.3346/jkms.2015.30.9.1367