title: Rapid recovery from acute myocarditis under levosimendan treatment: report of two cases.
abstract: OBJECTIVE
  Acute viral myocarditis (AVM) is an inflammatory heart disease that may lead to acute heart failure caused by cardiomyocyte loss. AVM may result in fatal outcome due to hemodynamic compromise. There is no specific treatment for AVM. Treatment is generally same as the treatment of conventional heart failure. Levosimendan is a new molecule with inotropic and vasodilator effect and is widely used for acute decompensated heart failure.
  
  
  METHODS
  Case 1: A 48-years-old, previously healthy male patient admitted to our clinic with complaints of acute onset of rest dyspnea and orthopnea, started the day before. Cardiac chambers were enlarged on echocardiography with global hypokinesia and ejection fraction (EF) was 25%. The patient was diagnosed as AVM complicated with decompensated heart failure. Continuous infusion of 0·2 μg/kg/min levosimendan for 24 h with treatment of conventional heart failure. Echocardiographic follow-up revealed a rapid improvement in left ventricular EF (50%) after 24 h. Case 2: A 33-years-old male patient admitted to our clinic with new onset shortness of breath and palpitation complaints. Echocardiography revealed enlarged left heart cavities with global hypocinesia (EF was 25%). The patient was diagnosed as AVM complicated with decompensated heart failure. Continuous infusion of 0·2 μg/kg/min levosimendan for 24 h with treatment of conventional heart failure. Echocardiography revealed dramatic improvement of left ventricular systolic function (EF = 55%) 24 h later.
  
  
  CONCLUSIONS
  To our knowledge, there is no report or study on levosimendan therapy for AVM in humans to date. Herein, we share two cases that revealed dramatic improvement in the myocardial function with levosimendan usage during the early phase of AVM.
authors: Cardiology Department, School of Medicine, Gaziantep University, Gaziantep, Turkey. sleymanercan@yahoo.com
authors: Suleyman
authors: S
authors: Ercan
authors: Vedat
authors: V
authors: Davutoglu
authors: Musa
authors: M
authors: Cakici
authors: Emre
authors: E
authors: Kus
authors: Hayri
authors: H
authors: Alici
authors: Ibrahim
authors: I
authors: Sari
mesh_terms: D000208:Acute Disease; D000328:Adult; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004452:Echocardiography / Q000379:methods; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000188:drug therapy*; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan