ACUTE FULMINANT MYOCARDITIS-MECHANICAL CIRCULATORY SUPPORT A CHANCE TO RECOVERY. (original) (raw)

Abstract Acute–fulminant myocarditis is a disease with unclear pathophysiology and etiology, difficult diagnosis anf very large spectrum of clinical presentation. Very rare is presentation with hemodynamic instability or franc acute cardiogenic shock. Such patients if the diagnosis is not giant cell myocarditis, have an excellent prognosis for complete long term recovery if they are supported aggressively. An aggressive approach to the use of mechanical support is strongly recommended. Survival,either by bridge to transplantation or recovery, should approach 70%. Transplantation should and can offten be avoided. We present a young, 24 years female, with acute-fulminant myocarditis with chlamidia pneumoniae and Parvovirus B19, acute cardiogenic shock, which was first supported by ECMO for 48 hours and then Thoratec bi-ventricular assist device, to support her hemodynamic. After two weeks, she recovered with normal cardiac function and was weaned from mechanical circulatory support. This case report, show that full cardiac recovery is possible and even likely despite fulminant and catastophic presentation, avoiding a cardiac transplantation whit his implication.