Fulminant myocarditis (FM) is an unusual clinical condition and an acute type of myocarditis, the main feature of which is a rapidly progressing clinical path requiring hemodynamic help. Despite the common medical opinion of the past decades, recent comprehensive data, including a recent record comparing FM with acute non-FM, highlighted that FM has poor in-hospital outcome, frequently needs advanced hemodynamic support, and may result in residual left ventricular dysfunction in survivors.
In a new Scientific Statement (Statement) from the American Heart Association on how best to reduce fatalities from this rare condition, the resources needed to treat fulminant myocarditis are outlined. The statement is published today in Circulation, the Association’s leading cardiovascular journal.
Fulminant myocarditis, frequently caused by a viral infection, occurs unexpectedly and often with severe severity, resulting in an extremely high risk of death due to cardiovascular shock (heart failure to pump enough blood), fatal arrhythmias (abnormal heartbeat) and multi-organ failure. With many of today’s advances in technology, numerous devices can fully support the circulation and oxygenation/ventilation of a patient when needed.
Early recognition of fulminant myocarditis, institution of circulatory support and end-organ function maintenance (especially avoiding prolonged neurological hypoxemia) can lead to favorable results for this previously almost universally fatal condition.
The latest Declaration outlines growing awareness and education among health care providers of fulminant myocarditis to promote assessment, diagnosis and treatment. Optimal outcome treatment options include assisting patients through the use of extracorporeal life support (heart-lung machine), percutaneous and robust ventricular aid devices (heart pump aid devices) and heart transplantation.