Echocardiography in Fulminant Myocarditis

Abstract

AbstractThe diagnosis of fulminant myocarditis (FM) can be challenging. Echocardiography is recommended as an initial imaging tool in patients with suspected FM. Although it lacks specific diagnostic value, timely and thorough echocardiographic evaluation is important in excluding other similar critical cardiac conditions and differentiating FM from non-FM. Typical findings in FM include severe and diffuse left ventricular (LV) systolic dysfunction with rapid dynamic changes, transiently thickened LV wall (sometimes LV wall is thick to 20–25 mm; Usually 12–14 mm) is and relatively normal ranged LV chamber size. Pericardial effusion in small amount is also common and intra-cardiac thrombus is seen occasionally. In addition to aid diagnosis, echocardiography can also provide prognostic information in FM. Due to the dynamic changes of cardiac function in FM, serial echocardiographic scans are warranted to monitor disease progression and guide management. Myocardial strain and layerspecific strain analysis by advanced modality as speckle-tracking echocardiography (STE) may have added value in diagnosis and prognosis of FM and future research is needed in this area.