Fulminant myo
carditis (FM) sometimes
causes severe left ventri
cular dysfun
ction and lethal arrhythmias leading to
cardiogeni
c sho
ck and
criti
cal
conditions. Thus, me
chani
cal
cir
culation support with intra-aorti
c balloon pumping and/or a
cardiopulmonary support system (CPS) is sometimes needed to save lives. The spe
cial re
commended therapies for FM for that
classified as
class I (eviden
ce level C) in the guidelines of the Japanese Cir
culation So
ciety are intra-aorti
c balloon pumping, CPS, per
cutaneous
cardia
c pa
cing, and a left ventri
cular assist devi
ce (LVAD), and they are well established in eviden
ce-based medi
cine. We experien
ced a
case of FM that we were able to save by long-term stable CPS support. Be
cause, unfortunately, the LVAD was not
commer
cially available in Japan at that time, intensive treatments in
cluding CPS were
continued in our hospital. Finally, a good
course of the illness was a
chieved without any adverse
compli
cations. Thus, these intensive treatments in the present
case may be one of the optional effe
ctive strategies for FM, espe
cially in hospitals and/or
countries where the LVAD is not (
commer
cially) available, and when an LVAD may not be suitable be
cause of
compli
cations asso
ciated with infe
ctious disease.
<class="boldFont">Learning objective: Intensive treatment including cardiopulmonary support system as in this case may be one of the optional effective strategies for fulminant myocarditis, especially in hospitals and/or countries where left ventricular assist devices (LVAD) are not (commercially) available, and when an LVAD may not be suitable because of complications associated with infectious disease.>