TITLE:
Clinical Feature of Japanese Patients with Fulminant Myocarditis—Myocarditis in Japanese Patients
AUTHORS:
Hiroaki Kawano, Yasuhiro Nagayoshi, Sunao Kojima, Nahoko Kakihara, Satoshi Sakuma, Masumi Uchino, Aiko Komatsu, Machiko Asaka, Mitsuhiro Shimomura, Hiroshige Yamabe, Hisao Ogawa, Koichi Node
KEYWORDS:
Myocarditis, Mechanical Support, Immunosuppressive Therapy, Immunomodulation Therapy
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.2 No.3,
July
22,
2011
ABSTRACT: Fulminant myocarditis is commonly recognized as an acute myocarditis with cardiogenic shock requiring mechanical support systems. Before the development of mechanical assist devices, previous study described that most of patients with fulminant myocarditis die at acute phase because of rapidly progressive cardiac decompensation. To investigate the feature of myocarditis, we checked consecutive 18 patients (10 men, 8 women, 12yr-80yr) from April in 2001 to September 2008 in University. Of these patients 3 needed intraaortic balloon pumping (IABP) (2 men, 1 woman), 6 did both IABP and percutaneous cardiopulmonary support (PCPS) (2 men, 4 women). Three patients who need both IABP and PCPS died (2 men, 49yr and 65yr, 1 woman, 54yr) because of uncontrolled bacterial infection. No patients whose age was under 40yr (5 men, 4 women) died although a man needed IABP and 3 women did both IABP and PCPS. Sixteen patients were able to resume a normal life although 1 male patient needed permanent pacemaker, 1 female did cardiac resynchronization therapy, and a male and a female had left ventricular systolic dysfunction. In conclusion, the young patients had better prognosis than older even if mechanical assist is needed. Although half of patients needed mechanical assist, the prevention of multi-organ complications including bacterial infection is one of the most important keys in the treatment of fulminant myocarditis.