Clinical Analysis Of Acute Severe Myocarditis

Objective To better define the clinical feature and natural history of acute severeviral myocarditis by analyzing clinical course of patients with acute severe viralmyocarditis.Methods The c linical presentation, diagnosis, therapy and prognosis of patientswho were admitted in our hospital from January 2004 to January 2007 for acutesevere viral myocarditis were analyzed retrospectively.Results A total of 14 patients with acute severe viral myocarditis (male 4 andfemale 10, aged from 16 to 60 years old, with a mean age 40.3±14.1 years) wereanalyzed. Some patients presented life-threatening arrhythmia(50%), heartfailure(21.4%), cardiogenic shock(7.1%), even sudden death(7.1%). Three patientscomplicated with other organs injury resulting in multiple organ dysfunction. ECGabnormalities, abnormal echocardiography findings, elevated serum troponin andcreatine kinase were presented in these 14 patients. Serum e nteroviral RNA andCoxsackie viral IgM were detected in 4 and 2 patients respectively. Two of 14patients died in the active phase of this disease.Conclusion The clinical feature of patients with acute severe viral myocarditis isvery serious and varied. Although there are a lot of diagnostic and evaluating methods, the positive rate and specificity of some tests are still low. Supportive care is the first line of treatment, including hemodynamic support and inflammation inhibition, and complication prevention.