Three Cases of Fulminant Myocarditis Recovered with Early Administration of Percutaneous Cardiopulmonary Support

概要

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Three patients with fulminant myocarditis were admitted from 1998 to 2001. Although Influenza virus infection could cause his myocarditis of case 2, the etiology of other two cases were not identified. All cases had cardiogenic shock and two cases had life-threatening ventricular arrythmia. Hemodynamic instability was refractory to cathecholamine and all the three cases needed intra aortic balloon pumping (IABP) and percutaneous cardiopulmonary support (POPS) between 12 and 24 hours from admission. Although local hemorrhage and hemolytic anemia were complicated with extracorporeal circulation in all three cases, ischemia of lower limbs was not observed.Hemodynamic stability made it possible to remove from extracorporeal circulation from 7 to 9 days after administration. Although medical therapy with steroid hormone was performed in all cases, the aim was not for their myocarditis but for the hemodynamic stabilization in case 1, for the treatment of interstitial pneumonitis in case 2 and for the prevention of bronchial asthma and hemodynamic stabilization in case 3. Two patients had another medical therapy with angiotensin converting enzyme inhibitor, one of them with beta blocking agent, the other patient had no medication. Early administration of IABP and POPS could be benefical for their good recovery.
一般社団法人国立医療学会の論文