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Initial Tn levels were elevated (21.8 11.9 ng/dl) in the patient group. The absolute level of Tn could not differentiate patients who would survive or not. Nevertheless, daily Tn level over the first 72 hours clearly showed that patients with a steep decline in Tn (6.53 3.73, ranged from 2.494 to 14.8, n 13) were able to be weaned off mechanical support (Figure 1). This finding may suggest that initially high Tn values do not necessarily indicate irreversible damage to the myocardium; rather, rapid decline in Tn slope may reflect early recovery of the myocardium. Conversely, initial Tn levels, even if not particularly elevated, might reflect irreversible damage of the myocardium without good prospects for recovery if they remain persistently elevated. Figure 1. Trend of daily troponin (Tn) levels. Patients 1 to 5 used Tn T, and the others used Tn I. There are similarities in the slope in reversible fulminant myocarditis, 6.53 3.73 ng/ml/day (n 13; patient 12 with failed weaning and patient 10 with only one Tn datum were excluded from analysis).
Two-dimensional echocardiograms from patients with fulminant and acute myocarditis at presentation. The top panels show the parasternal long axis (A) and short axis (B) views of a 20-year-old man with fulminant myocarditis who presented after five days of a viral syndrome followed by acute hemodynamic collapse. Note the severe ventricular thickening (septal thickness 2.1 cm) but small ventricular cavity size (LVEDD 2.5 cm). After hemodynamic support with intravenous inotropic agents and a left ventricular assist device, this patient recovered near normal left ventricular function. Echo of normal heart – Parasternal View
Page 1 and 2:
A CASE REPORT: ECMO SUPPORT FOR FUL
Page 3 and 4: MYOCARDITIS: DEFINITION • Myocard
Page 5 and 6: CLASSIFICATION • Etiology • Ex:
Page 7 and 8: Phase I: Viral Infection • Cardio
Page 9 and 10: PHASE III: CELL-MEDIATED IMMUNITY
Page 11 and 12: FIGURE 1 PATHOGENESIS OF VIRAL MYOC
Page 13 and 14: HISTORY & PHYSICAL • 24 year old
Page 15: ICU AND RIGHT HEART CATH • VTach
Page 19 and 20: MUSC-ECMO •Equipment: •Stockert
Page 21: • Cardiac Stun: ECHO: DAY 1 OF EC
Page 26 and 27: ECHO: DAY 6 OF ECMO • Trial Off-
Page 28 and 29: 6 14 20 34 38 46 54 62 70 82 90 102
Page 30 and 31: fib (mg/dL) 215 191 208 229 233 306
Page 35 and 36: EF (%) 80 Patient EF Through Hospit
Page 37 and 38: CLINICAL PRESENTATION OF MYOCARDITI
Page 39 and 40: METHODS OF FM DIAGNOSIS • Echocar
Page 41 and 42: LABORATORY EVIDENCE FOR FM VS. ACUT
Page 43 and 44: Fulminant Chronic HISTOLOGICAL CLAS
Page 46: LONG-TERM OUTCOME OF FULMINANT MYOC
Page 49 and 50: EXPERIENCE AND RESULT OF ECMO IN TR
Page 51: CONCLUSION Teamwork and aggressive
Page 56 and 57: #3 JOURNAL OF THE AMERICAN COLLEGE
Page 58 and 59: FAVOURABLE CLINICAL OUTCOME IN PATI
Page 60 and 61: SPINALE IDEAS • Myocardial stanni
Page 62 and 63: FIGURE 2. A CASE OF FULMINANT MYOCA
Page 64 and 65: CALL FOR ABSTRACTS ABSTRACTS FOR CA
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