D'Ettore Nicoletta, Eghbalzadeh Kaveh, Oezkur Mehmet, Bertoldi Letizia F, Bossard Matthias, Pappalardo Federico
Department of Cardiology, San Giacomo Hospital, Novi Ligure - AS LAL, Via Edilio Raggio 12, Alessandria 15067, Italy.
Department of Cardiac Surgery, Heart Center Bonn, University Hospital Bonn, 53127 Bonn, Germany.
Eur Heart J Suppl. 2025 Feb 4;27(Suppl 4):iv23-iv30. doi: 10.1093/eurheartjsupp/suaf004. eCollection 2025 Apr.
Fulminant myocarditis (FM) is a progressive and severe form of acute myocarditis, complicated by cardiogenic shock. The clinical presentation and aetiologies of FM are often heterogeneous, making it difficult to diagnose. Irrespective of how FM presents, it rapidly evolves to haemodynamic deterioration and requires prompt treatment to stabilize. As such, the use of mechanical circulatory support (MCS) devices has emerged as a critical intervention to achieve haemodynamic support, early unloading, and systemic perfusion and to prevent multiorgan dysfunction in patients with FM. Although scientific societies have proposed recommendations and management pathways, due to the heterogeneity in FM, there remains a lack of clarity in the diagnostic pathway and selection of MCS device for this young patient population. This review provides an updated and integrated overview of the diagnostic flow and important clinical considerations when managing patients with FM.
暴发性心肌炎（FM）是急性心肌炎的一种进行性严重形式，常并发心源性休克。FM的临床表现和病因往往具有异质性，难以诊断。无论FM如何表现，它都会迅速发展为血流动力学恶化，需要及时治疗以稳定病情。因此，使用机械循环支持（MCS）设备已成为实现血流动力学支持、早期减负和全身灌注以及预防FM患者多器官功能障碍的关键干预措施。尽管科学协会已经提出了建议和管理途径，但由于FM的异质性，对于这一年轻患者群体的诊断途径和MCS设备的选择仍不明确。本综述提供了在管理FM患者时诊断流程和重要临床考虑因素的最新综合概述。
