A child with fulminant acute myocarditis rescued with extracorporeal membrane oxygenation

Introduction: Fulminant acute myocarditis (FAM) occurs rapidly, causes pump failure or lethal arrhythmias, sometimes leading to death by cardiogenic shock. Case Report: We hereby present a three-year-old girl, previously asymptomatic, who developed rapid onset tachycardia, hypotension and cardiorespiratory arrest following an episode of respiratory tract infection. The patient was treated with anti-arrhythmic drugs, inotropes, and cardioversion after being diagnosed as atrial tachycardia, but the rhythm did not revert to sinus rhythm. Due to deteriorating condition patient was put on extra corporeal membrane oxygenation (ECMO) and supported for 131 hours along with supportive and IVIG treatment. After improvement in ejection fraction, patient was weaned off ECMO. The rhythm reverted to sinus after three days of admission and antiarrhythmics were gradually tapered. Patient was discharged on 17th day of admission in a stable condition with an ejction fraction of 58%. Conclusion: Timely extracorporeal membrane oxygenation (ECMO) support in fulminant acute myocarditis (FAM) with refractory atrial tachycardia and shock due to myocarditis, along with medical treatment could prevent lethal outcomes.