TY - JOUR
T1 - Clinical Management of Acute myocarditis in daily practice
T2 - an expert practical view
AU - Kerneis, Mathieu
AU - Ammirati, Enrico
AU - Delmas, Clément
AU - Heggermont, Ward
AU - Heymans, Stephane
AU - Lenz, Max
AU - Madonna, Rosalinda
AU - Morosin, Marco
AU - Schaubroeck, Hannah
AU - Sionis, Alessandro
AU - Tsaban, Gal
AU - Uzokov, Jamol
AU - Vardanyan, Katarine
AU - Vandenbriele, Christophe
AU - Roubille, François
PY - 2025/4/8
Y1 - 2025/4/8
N2 - BACKGROUND: Acute Myocarditis (AM) encompasses a broad spectrum of clinical presentations and causes. Despite the recent advances in cardiovascular imaging, pathology, virology and genetics, specific therapies are still lacking. PURPOSE: This collaborative review aims to analyze the current evidence to answer practical questions that physicians may face during the early management of patients presenting with an acute form of the disease, complicated or not.This review analyzes current evidence to address practical questions posed by acute cardiovascular physicians during the early management of acute, often fulminant, myocarditis. METHODS AND RESULTS: Based on the current literature, this review provides a step-by-step approach to treat AM patients from their admission in the cardiac intensive care unit (CICU) to discharge, by answering 10 clinical questions: Might this patient be suffering from an AM? Should I hospitalize this patient and, if so, where? Which cardiac imaging exam should I perform and what can I learn from it? Is this patient requiring an EMB? What should the non-invasive etiological work-up be? Is his episode of AM of viral, toxic, or other origin? Does this patient need specific treatments or mechanical circulatory support? Is there an indication for guideline-directed medical heart failure treatment? When can the patient be discharged and resume physical activity? Notably, this review highlights the need to build a multidisciplinary response team to address the many diagnostic and therapeutic challenges of AM patients. It also points out the lack of evidence to guide treatment of these patients.
AB - BACKGROUND: Acute Myocarditis (AM) encompasses a broad spectrum of clinical presentations and causes. Despite the recent advances in cardiovascular imaging, pathology, virology and genetics, specific therapies are still lacking. PURPOSE: This collaborative review aims to analyze the current evidence to answer practical questions that physicians may face during the early management of patients presenting with an acute form of the disease, complicated or not.This review analyzes current evidence to address practical questions posed by acute cardiovascular physicians during the early management of acute, often fulminant, myocarditis. METHODS AND RESULTS: Based on the current literature, this review provides a step-by-step approach to treat AM patients from their admission in the cardiac intensive care unit (CICU) to discharge, by answering 10 clinical questions: Might this patient be suffering from an AM? Should I hospitalize this patient and, if so, where? Which cardiac imaging exam should I perform and what can I learn from it? Is this patient requiring an EMB? What should the non-invasive etiological work-up be? Is his episode of AM of viral, toxic, or other origin? Does this patient need specific treatments or mechanical circulatory support? Is there an indication for guideline-directed medical heart failure treatment? When can the patient be discharged and resume physical activity? Notably, this review highlights the need to build a multidisciplinary response team to address the many diagnostic and therapeutic challenges of AM patients. It also points out the lack of evidence to guide treatment of these patients.
KW - Myocarditis
KW - acute cardiovascular care
KW - arrhythmias
KW - heart failure
KW - inflammation
U2 - 10.1093/ehjacc/zuaf057
DO - 10.1093/ehjacc/zuaf057
M3 - Article
SN - 2048-8726
JO - European Heart Journal: Acute Cardiovascular Care
JF - European Heart Journal: Acute Cardiovascular Care
ER -