Abstract

Fulminant myocarditis is caused majorly by the infection of various viruses. It arises quickly, progresses rapidly, and may lead to severe heart failure or

circulatory failure presenting as hypotension and cardiogenic shock in a short time, and its mortality is up to 50-70%. The most importantly, there are no

treatment options, and no treatment guidelines or expert consensus statement.

Here, we provide first expert consensus, Chinese Society of Cardiology Expert Consensus Statement on the Diagnosis and Treatment of Fulminant Myocarditis, based on the data of our recent registered clinical trial. In this statement, we described its clinical features and diagnostic criteria, and importantly, first time we described a new treatment regimen, “life support-based comprehensive treatment regimen”. This treatment regimen includes serious managements of nutrients and fluids, sufficient doses of glucocorticoid, immunoglobulin, antiviral reagents, continuous renal replacement therapy and life-support treatments including applications of mechanical respirators and circulatory support systems, intraaortic balloon pulsation (IABP) and extracorporeal membrane oxygenation (ECMO) as well as cardiac pacemaker if it is needed. Our practice in multiple cardiac centers demonstrates this treatment can dramatically lower the mortality of the patients with fulminant myocarditis.