Skip to main content
main-content

01.11.2018 | Myocardial Disease (A Abbate, Section Editor) | Ausgabe 11/2018

Current Cardiology Reports 11/2018

Acute and Fulminant Myocarditis: a Pragmatic Clinical Approach to Diagnosis and Treatment

Zeitschrift:
Current Cardiology Reports > Ausgabe 11/2018
Autoren:
Enrico Ammirati, Giacomo Veronese, Manlio Cipriani, Francesco Moroni, Andrea Garascia, Michela Brambatti, Eric D. Adler, Maria Frigerio
Wichtige Hinweise
This article is part of the Topical Collection on Myocardial Disease

Abstract

Purpose of Review

To review the clinical features of acute myocarditis, including its fulminant presentation, and present a pragmatic approach to the diagnosis and treatment, considering indications of American and European Scientific Statements and recent data derived by large contemporary registries.

Recent Findings

Patients presenting with acute uncomplicated myocarditis (i.e., without left ventricular dysfunction, heart failure, or ventricular arrhythmias) have a favorable short- and long-term prognosis: these findings do not support the indication to endomyocardial biopsy in this clinical scenario. Conversely, patients with complicated presentations, especially those with fulminant myocarditis, require an aggressive and comprehensive management, including endomyocardial biopsy and availability of advanced therapies for circulatory support. Although several immunomodulatory or immunosuppressive therapies have been studied and are actually prescribed in the real-world practice, their effectiveness has not been clearly demonstrated. Patients with specific histological subtypes of acute myocarditis (i.e., giant cell and eosinophilic myocarditis) or those affected by sarcoidosis or systemic autoimmune disorders seem to benefit most from immunosuppression. On the other hand, no clear evidence supports the use of immunosuppressive agents in patients with lymphocytic acute myocarditis, even though small series suggest a potential benefit.

Summary

Acute myocarditis is a heterogeneous condition with distinct pathophysiological pathways. Further research is mandatory to identify factors and mechanisms that may trigger/maintain or counteract/repair the myocardial damage, in order to provide a rational for future evidence-based treatment of patients affected by this condition.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Nicht verpassen: e.Med bis 13. März 2019 100€ günstiger im ersten Jahr!

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 11/2018

Current Cardiology Reports 11/2018 Zur Ausgabe

Myocardial Disease (A Abbate, Section Editor)

Non-coding RNA in Ischemic and Non-ischemic Cardiomyopathy

Echocardiography (JM Gardin and AH Waller, Section Editors)

What Is the Clinical Utility of Intravascular Ultrasound?

Myocardial Disease (A Abbate, Section Editor)

Tumor Necrosis Factor-α in Heart Failure: an Updated Review

Peripheral Vascular Disease (CJ Cooper and R Gupta, Section Editors)

Pulmonary Embolism for the Cardiologist: Emphasis on Diagnosis

Echocardiography (JM Gardin and AH Waller, Section Editors)

Echocardiography in Sarcoidosis

  1. Sie können e.Med Radiologie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.


 

Neu im Fachgebiet Kardiologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Kardiologie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise