Abstract
A man in his forties visited his primary care physician after four days of exhibiting common cold-like symptoms. He was in a state of cardiogenic shock with elevated liver enzymes (AST/ALT 2,426/1,835 IU/l) when brought to our hospital. On admission, his blood pressure was 90/68mmHg, heart rate was 120bpm, and SpO2 was 80%. Echocardiography showed severe cardiac dysfunction (%FS 3%) and pericardial effusion and the electrocardiogram revealed ST-T wave changes. His clinical manifestation and acute progressing left ventricular heart failure was diagnosed as fulminant myocarditis. Percutaneous cardiopulmonary support (PCPS) and intraaortic balloon pump (IABP) were introduced. Catecholamine, Carperitide and human immuno-globulin were also used. 50 hours after admission, his blood pressure was detected. PCPS was removed on the 4th day and IABP on the 5th day. He recovered but on the 6th day, echocardiography and enhanced CT found a left ventricular thrombi (φ=13mm×13mm). We removed this round-shaped thrombi surgically because of it's embolic potential while recovering from fulminant myocarditis. He discharged from our hospital 45 days after admission without any complications.
