Korean J Med.  2015 Oct;89(4):439-443. 10.3904/kjm.2015.89.4.439.

How Long Should We Wait for Recovery from Acute Fulminant Myocarditis?

• Chung JH
• Jung IH
• Kim TH

• KMID: 2268977
• DOI: http://doi.org/10.3904/kjm.2015.89.4.439

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.

Keyword

Myocarditis; Heart failure; Extracorporeal membrane oxygenation

MeSH Terms

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