Myocarditis: a primer for intensivists

Article Cardiac & Cardiovascular Systems

Outcomes With Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Suspected Acute Myocarditis: 10-Year Experience From the Extracorporeal Life Support Organization Registry

Jose I. Nunez et al.

Summary: Acute myocarditis requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO) treatment is associated with improved survival rates compared to overall population receiving VA-ECMO therapy. Major modifiable risk factors for mortality in myocarditis patients include ongoing cardiopulmonary resuscitation requiring ECMO and markers of illness severity prior to ECMO.

CIRCULATION-HEART FAILURE (2023)

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Review Medicine, General & Internal

Diagnosis and Treatment of Acute Myocarditis A Review

Enrico Ammirati et al.

Summary: Acutemyocarditis is a sudden inflammatory injury to the myocardium, affecting around 4 to 14 people per 100 000 annually with a mortality rate of about 1% to 7%. The most common causes include viruses, autoimmune disorders, drugs, and vaccines. Symptoms include chest pain, dyspnea, and syncope. Diagnosis can be made through symptoms, biomarkers, electrocardiographic changes, and imaging/biopsy. Treatment depends on the severity, clinical presentation, and etiology.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2023)

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Review Cardiac & Cardiovascular Systems

State-of-the-Art of Endomyocardial Biopsy on Acute Myocarditis and Chronic Inflammatory Cardiomyopathy

Enrico Ammirati et al.

Summary: This review discusses the application of endomyocardial biopsy (EMB) in the diagnosis of myocarditis, including the indications, strengths, and shortcomings of EMB techniques and the ongoing innovations in this field. EMB provides unique diagnostic and prognostic information for myocarditis. Recent technological advancements have improved the utility of EMB.

CURRENT CARDIOLOGY REPORTS (2022)

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Review Medicine, General & Internal

Immunomodulating Therapies in Acute Myocarditis and Recurrent/Acute Pericarditis

Enrico Ammirati et al.

Summary: The field of cardio-immunology is rapidly evolving due to the use of non-invasive diagnostic tools and immunomodulating therapies. Recent data suggest the effectiveness of these therapies in autoimmune disorders, isolated forms of myocarditis, and severe cases of COVID-19. Ongoing clinical trials are also evaluating the use of specific medications in the treatment of acute myocarditis and recurrent pericarditis. The interaction between the cardiac and immune systems is being studied using new research models introduced by immune-mediated therapies in oncology.

FRONTIERS IN MEDICINE (2022)

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Article Cardiac & Cardiovascular Systems

Features and Outcomes of Histologically Proven Myocarditis With Fulminant Presentation

Koshiro Kanaoka et al.

Summary: The study found that patients with fulminant myocarditis presentation are at higher risk of death or heart transplantation within 90 days. Factors associated with poorer prognosis include older age, non-sinus rhythm, low left ventricular wall motion, and ventricular tachycardia or fibrillation upon admission.

CIRCULATION (2022)

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Article Cardiac & Cardiovascular Systems

Safety of Endomyocardial Biopsy in New-Onset Acute Heart Failure Requiring Veno-Arterial Extracorporeal Membrane Oxygenation

Robert M. A. van der Boon et al.

Summary: EMB in patients requiring VA-ECMO can be performed to provide histopathologic diagnosis, primarily myocarditis, with a substantial risk of major complications. The important therapeutic and prognostic implications of establishing an underlying pathogenesis causing new-AHF warrant further refinement to improve procedural safety.

CIRCULATION-HEART FAILURE (2021)

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Article Cardiac & Cardiovascular Systems