Clinical features and prognosis in Chinese patients with acute fulminant myocarditis

Objective There is still a lack of large-scale studies focusing on acute fulminant myocarditis (AFM) and knowledge of this disease is unimpressive. To better understand the clinical features of AFM and improve the diagnosis and treatment of this disease, we analysed the data of consecutive Chinese AFM patients admitted to our department. Methods This retrospective observational study analysed the data of 40 patients with a diagnosis of AFM admitted to our hospital between January 2003 and March 2010. Results The mean age of patients was 28.5 +/- 18.4 years and 70% of patients were females. 90.0% of patients had a short viral prodrome, 77.5% had cardiogenic shock and 35.0% had multiple organ failure, especially hepatic dysfunction. The most common manifestations in ECG were low voltage in the limb leads (87.5%) and sinus tachycardia (75%). Myocardial infarctions like ECG changes were not uncommon. Left ventricular ejection fraction (LVEF) was significantly reduced (25.3 +/- 7.5%), but the left cardiac sizes were normal. More than 90% of the patients were treated with glucocorticoids. 5.0% needed an intra-aortic balloon pump (IABP), and 35.0% were treated with bi-level positive airway pressure (BiPAP). In all, 39(95.0%) patients were discharged alive and one man died from ventricular fibrillation. LVEF and left cardiac chambers at follow-up did not change as compared with discharge. No death, new onset heart failure or arrhythmias occurred during the follow-up. Conclusions This study describes the clinical features of Chinese AFM patients. The short- and mid-term prognosis of AFM is good. AFM patients may benefit from a treatment with glucocorticoids.