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KMID : 0191120150300091367
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Journal of Korean Medical Science
2015 Volume.30 No. 9 p.1367 ~ p.1372
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Pathological Substratum for a Case of Fulminant Myocarditis Treated with Extracorporeal Membrane Oxygenation and Subsequent Heart Transplantation
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Kim In-Ae
Yang Hyun-Suk
Kim Wan-Seop
Chee Hyun-Keun
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Abstract
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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.
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KEYWORD
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Fulminant Myocarditis, Complete Atrioventricular Block, Extracorporeal Membrane Oxygenation, Orthotopic Heart Transplantation
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