A synopsis of the guidelines for diagnosis and treatment of fulminant myocarditis

Fulminant myocarditis (FM) represents the most severe subtype of myocarditis, associated with a high in-hospital mortality. For the clinical management of FM, the “life support-based comprehensive treatment regimen” is recommended, which places emphasis on suppressing the core pathophysiological mechanisms underlying FM, namely the excessive activation of innate immune responses and the inflammatory storm. Mechanical circulatory support and immunomodulatory therapy with adequate doses of both glucocorticoids and immunoglobulins constitute the two foundational pillars of this regimen. Notably, the treatment regimen underscores the principle of “ultra-early recognition, ultra-early diagnosis, ultra-early prediction, and ultra-early rescue”. As the first clinical guideline for the diagnosis and treatment of adult FM, this document provides evidence-based and effective therapeutic approaches, which are crucial for significantly reducing mortality and improving long-term prognosis in affected patients.