How Long Should We Wait for Recovery from Acute Fulminant Myocarditis?.
10.3904/kjm.2015.89.4.439
- Author:
Jae Hoon CHUNG
1
;
In Hyun JUNG
;
Tae Hoon KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea. sch.kimtaehoon@gmail.com
- Publication Type:Case Report
- Keywords:
Myocarditis;
Heart failure;
Extracorporeal membrane oxygenation
- MeSH:
Biopsy;
Bradycardia;
Dyspnea;
Electrocardiography;
Extracorporeal Membrane Oxygenation;
Heart;
Heart Failure;
Heart Transplantation;
Hemodynamics;
Humans;
Middle Aged;
Muscle Cells;
Myocarditis*;
Necrosis;
Shock;
Stroke Volume;
United Nations
- From:Korean Journal of Medicine
2015;89(4):439-443
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 54-year-old diabetic man presented to the hospital with shock and bradycardia. His initial estimated left ventricular ejection fraction (LVEF) was 15% and the electrocardiogram showed a junctional escape rhythm with a wide QRS complex and no P wave. Intensive supportive therapy was initiated after inserting a pacemaker and starting extracorporeal membrane oxygenation. A myocardial biopsy confirmed acute lymphocytic myocarditis with extensive myocyte necrosis, and cardiac transplantation was planned. However, the patient survived without transplantation after vigorous hemodynamic support for 2 weeks. After discharge, he had limited activity for 4 months due to dyspnea caused by a reduced systolic heart function (LVEF, 21%) with a junctional escaped beat. His systolic function recovered markedly 6 months after stopping the hemodynamic support, with the presence of a P wave and narrowed QRS complex.
