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Current Heart Failure Reports

Erschienen in:

01.06.2014 | Management of Heart Failure (TE Meyer, Section Editor)

Management of fulminant myocarditis: A diagnosis in search of its etiology but with therapeutic options

verfasst von: Bernhard Maisch, Volker Ruppert, Sabine Pankuweit

Erschienen in: Current Heart Failure Reports | Ausgabe 2/2014

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Abstract

Fulminant myocarditis is a clinical syndrome with signs of acute heart failure, cardiogenic shock, or life-threating rhythm disturbances in the context of suspected myocarditis. It is not an etiological diagnosis, but may have different underlying causes and pathogenetic processes – viral, bacterial, toxic, and autoreactive. Clinical management of the disease entity at the acute stage involves hemodynamic monitoring in an intensive care unit or similar setting. Rapid routine work-up is mandatory with serial EKGs, echocardiography, cardiac MRI, heart catheterization with endomyocardial biopsy for histology, immunohistology, and molecular analysis for the underlying infection and pathogenesis. Heart failure therapy is warranted in all cases according to current guidelines. For fulminant autoreactive myocarditis, immunosuppressive treatment is beneficial; for viral myocarditis, IVIg can resolve the inflammation, reduce the viral load, and even eradicate the microbial agent. ECMO, IABP, ventricular assist devices, LifeVest, or ICD implantation can bridge to recovery or to heart transplantation.

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Titel: Management of fulminant myocarditis: A diagnosis in search of its etiology but with therapeutic options
verfasst von: Bernhard Maisch
Volker Ruppert
Sabine Pankuweit
Publikationsdatum: 01.06.2014
Verlag: Springer US
Erschienen in: Current Heart Failure Reports / Ausgabe 2/2014
Print ISSN: 1546-9530
Elektronische ISSN: 1546-9549
DOI: https://doi.org/10.1007/s11897-014-0196-6

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