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Early referral to tertiary centers with mechanical circulatory support and prompt endomyocardial biopsy are critical for managing fulminant myocarditis complicated by cardiogenic shock.
Acute myocarditis is an inflammatory disease of the myocardium with a highly variable clinical course. Fulminant myocarditis (FM) represents the most threatening scenario with hemodynamic compromise and cardiogenic shock at presentation. Despite medical advances and the availability of promising mechanical circulatory support (MCS), FM is burdened by a dismal prognosis. Early referral to tertiary hospitals with MCS facilities and prompt diagnosis with endomyocardial biopsy are critical steps toward optimal management. Moreover, beyond supportive care, the prevention of irreversible myocardial damage with immunomodulating therapies must be proven in clinical trials. In this editorial, we briefly describe current evidence and future perspectives regarding the management of myocarditis complicated by cardiogenic shock.
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Tavecchia et al. (2022) studied this question.
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