13th March 2024

The patient in the scenario above is in cardiogenic shock as a result of likely myocarditis. He is hemodynamically unstable and, therefore, warrants a critical care discussion at the first instance. As per the ESC guidelines, in cases of myocarditis where there is cardiovascular compromise, ventricular assist devices (VAD) or extracorporeal membrane oxygenation (ECMO) is recommended. Ultimately, it is likely this patient will require a cardiac transplantation and these aforementioned devices are seen as a bridge towards this. In many cases of fulminant myocarditis, the insult may be completely reversible and therefore, a transplant may be delayed in favour of further monitoring whilst on these ventricular assist devices.