Key result
Intravenous immunoglobulin and steroids led to rapid clinical improvement in a 59-year-old woman with deteriorating acute fulminant myocarditis.
Case Report (n=1)
Patients presenting with acute fulminant myocarditis of unknown etiology who deteriorate despite aggressive heart failure treatment may benefit from the addition of steroids and IVIG.
May warrant IVIG and steroids in refractory fulminant myocarditis; hypothesis-generating and requires randomized confirmation.
We report a case of a 59-year-old woman who presented with worsening dyspnea which rapidly progressed to severe heart failure. Coronary arteries showed no obstruction. Supportive measures stabilized the patient's hemodynamics. Initially intravenous solumedrol was given, but when the patient's condition continued to deteriorate, intravenous immunoglobulin (IVIG) was added to the treatment regimen and her condition improved. Studies show no benefit to using immunosuppressive agents in viral myocarditis, but benefits have been demonstrated in other etiologies. Patients presenting with acute fulminant myocarditis with unknown etiology that continue to deteriorate with aggressive heart failure treatment may benefit from steroids and IVIG.
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Barrie et al. (2012) conducted a case report in Acute fulminant myocarditis (n=1). Intravenous immunoglobulin (IVIG) and steroids (solumedrol) was evaluated. Intravenous immunoglobulin and steroids led to rapid clinical improvement in a 59-year-old woman with deteriorating acute fulminant myocarditis.
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