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Rapid recovery from acute myocarditis under levosimendan treatment: report of two cases
Author(s) -
Ercan Suleyman,
Davutoglu Vedat,
Cakici Musa,
Kus Emre,
Alici Hayri,
Sari Ibrahim
Publication year - 2013
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12038
Subject(s) - levosimendan , myocarditis , medicine , acute myocarditis , anesthesia , cardiology , intensive care medicine , heart failure
Summary What is known and Objectives Acute viral myocarditis ( AVM ) is an inflammatory heart disease that may lead to acute heart failure caused by cardiomyocyte loss. AVM may result in fatal outcome due to hemodynamic compromise. There is no specific treatment for AVM . Treatment is generally same as the treatment of conventional heart failure. Levosimendan is a new molecule with inotropic and vasodilator effect and is widely used for acute decompensated heart failure. Details of the cases Case 1: A 48‐years‐old, previously healthy male patient admitted to our clinic with complaints of acute onset of rest dyspnea and orthopnea, started the day before. Cardiac chambers were enlarged on echocardiography with global hypokinesia and ejection fraction ( EF ) was 25%. The patient was diagnosed as AVM complicated with decompensated heart failure. Continuous infusion of 0·2 μ g/kg/min levosimendan for 24 h with treatment of conventional heart failure. Echocardiographic follow‐up revealed a rapid improvement in left ventricular EF (50%) after 24 h. Case 2: A 33‐years‐old male patient admitted to our clinic with new onset shortness of breath and palpitation complaints. Echocardiography revealed enlarged left heart cavities with global hypocinesia ( EF was 25%). The patient was diagnosed as AVM complicated with decompensated heart failure. Continuous infusion of 0·2 μ g/kg/min levosimendan for 24 h with treatment of conventional heart failure. Echocardiography revealed dramatic improvement of left ventricular systolic function ( EF = 55%) 24 h later. What is new and Conclusion To our knowledge, there is no report or study on levosimendan therapy for AVM in humans to date. Herein, we share two cases that revealed dramatic improvement in the myocardial function with levosimendan usage during the early phase of AVM .