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KMID : 0882420150890040439
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Korean Journal of Medicine
2015 Volume.89 No. 4 p.439 ~ p.443
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How Long Should We Wait for Recovery from Acute Fulminant Myocarditis?
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Chung Jae-Hoon
Jung In-Hyun
Kim Tae-Hoon
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Abstract
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A 54-year-old diabetic man presented to the hospital with shock and bradycardia. His initial estimated left ventricular ejection fraction (LVEF) was 15% and the electrocardiogram showed a junctional escape rhythm with a wide QRS complex and no P wave. Intensive supportive therapy was initiated after inserting a pacemaker and starting extracorporeal membrane oxygenation. A myocardial biopsy confirmed acute lymphocytic myocarditis with extensive myocyte necrosis, and cardiac transplantation was planned. However, the patient survived without transplantation after vigorous hemodynamic support for 2 weeks. After discharge, he had limited activity for 4 months due to dyspnea caused by a reduced systolic heart function (LVEF, 21%) with a junctional escaped beat. His systolic function recovered markedly 6 months after stopping the hemodynamic support, with the presence of a P wave and narrowed QRS complex.
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KEYWORD
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Myocarditis, Heart failure, Extracorporeal membrane oxygenation
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