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 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.
Department of Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
In Ae
IA
Kim
Division of Cardiology, Department of Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Hyun Suk
HS
Yang
Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Wan Seop
WS
Kim
Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Hyun Keun
HK
Chee
D003131:Combined Modality Therapy / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D012769:Shock / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
Complete Atrioventricular Block; Extracorporeal Membrane Oxygenation; Fulminant Myocarditis; Orthotopic Heart Transplantation