Guidelines on the diagnosis and treatment of adult fulminant myocarditis

Recently, Wang Dao Wen's team at Huazhong University of Science and Technology published a paper titled " Chinese Society of Cardiology Guidelines on the Diagnosis and Treatment of adult fulminant myocarditis." This is the first release of diagnostic and treatment guidelines for adult fulminant myocarditis in China.

This guideline points out that the cytokine storm caused by the excessive activation of innate immunity and the rapid release of inflammatory factors by immune cells, also known as the "inflammatory storm," is the core cause of the rapid onset, rapid progression, severe condition, and high mortality rate of fulminant myocarditis.

It systematically summarizes the clinical evaluation content of patients with fulminant myocarditis from the collection of medical history, clinical symptoms, and related examinations; thus, the clinical diagnostic criteria and diagnostic process for fulminant myocarditis were established, and a "life support-based comprehensive treatment regimen" was proposed, emphasizing very early identification, diagnosis, prediction, and treatment.

The core content of the regimen includes two aspects: 1) mechanical life support -maintaining circulatory stability and ensuring organ perfusion with a mechanical circulatory device, allowing the failing heart to rest rather than raising blood pressure with cardiotonic and vasoactive drugs; 2) immunomodulatory therapy—the use of adequate doses of glucocorticoids and adequate doses of immunoglobulins to modulate immunity, which is the fundamental measure.

This regimen will reduce the mortality rate of patients with fulminant myocarditis from over 50% in the past to below 5%. The release of this guideline will better guide the clinical diagnosis and treatment of adult fulminant myocarditis, saving more lives.

The work is published in the journal Science China Life Sciences.

More information:
Wang Dao Wen et al, Chinese Society of Cardiology guidelines on the diagnosis and treatment of adult fulminant myocarditis, Science China Life Sciences (2024). DOI: 10.1007/s11427-023-2421-0

Provided by Science China Press