Study reveals fast action, right resources are key to treating fulminant myocarditis

The resources needed to treat fulminant myocarditis -- severe, inflammation of the heart that develops rapidly -- are outlined in a new Scientific Statement from the American Heart Association on how best to reduce fatalities from this rare condition. The study is published in the cardiovascular journal -- Circulation. Fulminant myocarditis, often caused by a viral infection, comes on suddenly and often with significant severity, resulting in an exceptionally high risk of death caused by cardiogenic shock -- the heart's inability to pump enough blood, fatal arrhythmias, and multiorgan failure. With many of today's technology advances, numerous devices can fully support a patient's circulation and oxygenation and ventilation when necessary. The early recognition of fulminant myocarditis, the institution of circulatory support and maintenance of end-organ function, especially avoiding prolonged neurologic hypoxemia, can result in favourable outcomes for this previously almost universally fatal condition. The new statement details increasing awareness and education of fulminant myocarditis among health care providers to speed evaluation, diagnosis, and treatment. Treatment options for optimal outcomes include supporting patients through the use of extracorporeal life support (heart-lung machine), percutaneous and durable ventricular assist devices (devices to help the heart pump) and heart transplantation. "It is fortunate that fulminant myocarditis is rare and that it usually presents in typically younger and healthier patients, rather than critically ill patients seen in the office or emergency department," said Leslie T Cooper, MD, FAHA, vice-chair of the Statement Writing Group."This is where there are the greatest opportunities: early diagnosis, rapid treatment and the ability of frontline clinicians to detect the subtle signs and symptoms of this serious condition."