Fulminant
myocarditis has been defined as the clinical manifestation of cardiac
inflammation with rapid-onset
heart failure and
cardiogenic shock. We
report on the case of a 23-yr-old
woman with
pathology-proven fulminant lymphocytic
myocarditis presenting
shock with elevated cardiac
troponin I and ST segments in V1-2, following sustained
ventricular tachycardia and a complete
atrioventricular block. About 55 min of intensive
cardio-pulmonary resuscitation, with
extracorporeal membrane oxygenation support, bridged the
patient to orthotopic
heart transplantation. The explanted
heart revealed diffuse lymphocytic infiltration and
myocyte necrosis in all four cardiac chamber walls. Aggressive mechanical circulatory support may be an essential
bridge for recovery or even
transplantation in
patients with fulminant
myocarditis with
shock.