Key result
V-A ECMO plus IABP supports full cardiac and neurological recovery after prolonged 38-hour asystole.
Why the study?
There are no reports of patients with fulminant myocarditis who recovered cardiac function after prolonged asystole despite mechanical circulatory support.
Case Report (n=1)
No
Appropriate mechanical circulatory support (V-A ECMO and IABP) can enable full cardiac and neurological recovery even after prolonged asystole in fulminant myocarditis.
May support extended mechanical support in select fulminant myocarditis; single case leaves open generalizability and requires prospective validation.
Key Clinical Message: Even if cardiac rhythm deteriorated to asystole in the clinical course of fulminant myocarditis, cardiac function may recover, and the patient may be discharged without brain damage, if circulation could be maintained by appropriate mechanical cardiac supports. Abstract: A 69-year-old man was diagnosed with fulminant myocarditis with circulatory collapse. His cardiac rhythm deteriorated to asystole on the second day; however, circulatory status was maintained through extracorporeal membrane oxygenation and intra-aortic balloon pumping. After 38 h-lasting asystole, his heart resumed beating. He was discharged without neurological deficits on Day 25.
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Akutsu et al. (2023) conducted a case report in Fulminant myocarditis with circulatory collapse (n=1). V-A ECMO and IABP was evaluated on Recovery of cardiac and neurological function. The patient achieved complete cardiac and neurological recovery after a 38-hour sustained asystole managed with V-A ECMO and IABP.
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