cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2019.9.n461cardio-461Research ArticleСтатьиСлучай фульминантного миокардитаThe Case of Fulminant Myocarditishttps://orcid.org/0000-0001-7923-0084ТитовВ. А.TitovV. A.

НИО некоронарогенных заболеваний сердца, аспирант

Department of non-coronary diseases, postgraduate student

titovvladislove@gmail.comШишковаА. А.ShishkovaA. A.

Врач-кардиолог

Cardiologist

anastasiia.shishkova@gmail.comМитрофановаЛ. Б.MitrofanovaL. B.

Зав. НИЛ патоморфологии

Head of the Department of Pathology

lubamitr@yandex.ruИвановаС. В.IvanovaS. V.

Врач кардиолог

Cardiologist

sonya.spbgmu16@gmail.comЗверевД. А.ZverevD. A.

Head of the Department of Interventional Cardiology

zverev_da@almazovcentre.ruМаричевА. О.MarichevA. O.

Врач анестезиолог реаниматолог

Critical care physician

marichev_ao@almazovcentre.ruМоисееваО. М.MoiseevaO. M.

Зав. НИО некоронарогенных заболеваний сердца

Head of the Department of non-coronary diseases

moiseeva_om@almazovcentre.ruФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииРоссияFederal State Budgetary Institution “Almazov National Medical Research Centre” of the Ministry of Health of the Russian FederationRussian Federation2019170920195999196Copyright © Kardiomag, 20192019KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/461

Фульминантный миокардит (ФМ) – тяжелая форма воспалительного поражения миокарда, развивающаяся стремительно в виде острой сердечной недостаточности, кардиогенного шока или жизнеугрожающих нарушений ритма сердца. ФМ требует интенсивного лечения, включающего лекарственную и механическую поддержку кровообращения и в ряде случаев – трансплантацию сердца. В качестве скринингового метода диагностики может использоваться эхокардиография. Магнитно-резонансная томография сердца часто невыполнима из‑за гемодинамической нестабильности больного, поэтому окончательный диагноз устанавливается с помощью эндомиокардиальной биопсии с гистологическим и иммуногистохимическим исследованием и молекулярно-генетическим анализом полученных биоптатов. Прогноз заболевания определяется гистологической картиной, однако в большинстве случаев после завершения острой стадии воспалительного процесса ФМ имеет благоприятный долгосрочный прогноз. В данной статье описан клинический случай ФМ и представлен обзор текущей литературы по диагностике и лечению данного заболевания.

Fulminant myocarditis (FM) is a severe form of inflammatory myocardial injury rapidly developing as acute heart failure, cardiogenic shock, or life-threatening disturbances of cardiac rhythm. FM requires intensive treatment including drug therapy, mechanical circulatory support, and in some cases – heart transplantation. Echocardiography can be used as a screening method of diagnostics. Magnetic resonance imaging of the heart often cannot be performed because of hemodynamic instability of a patient, therefore endomyocardial biopsy with histological and immunohistochemical studies as well as molecular-genetic analysis of obtained samples is required for final diagnosis. Prognosis of the disease is determined by histological picture. In most cases, after cessation of acute stage of the inflammatory process, FM has a favorable long-term prognosis. In this article we present a clinical case of FM and review of current literature on diagnosis and treatment of this disease.

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The authors declare that there are no conflicts of interest present.