Extracorporeal Cardiopulmonary Resuscitation for Management of Out-of-Hospital Cardiac Arrest in a Patient with Fulminant Myocarditis

Figure 1. Coronary angiography on presentation. (a) Right anterior oblique and caudal projection and (b) right anterior oblique and cranial projection of the left coronary arteries demonstrating mild coronary artery disease. (c) Cranial projection of the right coronary artery demonstrating mild coronary artery disease; extracorporeal membranous oxygenation venous cannula originating from the femoral vein and extending into the right atrium can be seen (arrow).

Figure 2. Transthoracic echocardiogram on admission demonstrating severe left ventricular (LV) systolic dysfunction with an ejection fraction of 20%. (a) Two-chamber view of LV end diastole and (b) LV end systole.

Figure 3. Cardiac magnetic resonance imaging of parasternal short axis. (a) T2-weighted images demonstrating extensive myocardial T2 elevation (arrow) of the left ventricle (LV) consistent with myocardial edema. (b) Extensive LV patchy, epicardial pattern of injury by late gadolinium enhancement (arrow) consistent with cellular membrane injury; there was no infarct scar seen. There was severe LV systolic dysfunction with an ejection fraction of 25%. These findings are consistent with a diagnosis of acute myocarditis.