Management of fulminant myocarditis: A diagnosis in search of its etiology but with therapeutic options View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-06

AUTHORS

Bernhard Maisch, Volker Ruppert, Sabine Pankuweit

ABSTRACT

Fulminant myocarditis is a clinical syndrome with signs of acute heart failure, cardiogenic shock, or life-threating rhythm disturbances in the context of suspected myocarditis. It is not an etiological diagnosis, but may have different underlying causes and pathogenetic processes - viral, bacterial, toxic, and autoreactive. Clinical management of the disease entity at the acute stage involves hemodynamic monitoring in an intensive care unit or similar setting. Rapid routine work-up is mandatory with serial EKGs, echocardiography, cardiac MRI, heart catheterization with endomyocardial biopsy for histology, immunohistology, and molecular analysis for the underlying infection and pathogenesis. Heart failure therapy is warranted in all cases according to current guidelines. For fulminant autoreactive myocarditis, immunosuppressive treatment is beneficial; for viral myocarditis, IVIg can resolve the inflammation, reduce the viral load, and even eradicate the microbial agent. ECMO, IABP, ventricular assist devices, LifeVest, or ICD implantation can bridge to recovery or to heart transplantation. More... »

PAGES

166-177

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11897-014-0196-6

DOI

http://dx.doi.org/10.1007/s11897-014-0196-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032064496

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24723087


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