32. Patient Perspective of Fulminant Myocarditis with Cardiogenic Shock
What does it feel like to have fulminant myocarditis? How does it feel to see a loved one on ECMO? What impact do healthcare heroes have on their patients' and their families'? Tune into this remarkable firsthand patient perspective as Chas and Julie Miller recount their experience with fulminant myocarditis. In Episode 31 we discussed the science & medicine of myocarditis. Now in Episode 32 we realize the emotions and human experience on the other side through the lens of a patient and his loving wife.\xa0Special messages from CCU nursing, Megan VanName, Alyssa Noonan, and Kelly Norsworthy, as well as Dr. Dan Choi, cardiac surgeon at Johns Hopkins Hospital. \n\n\n\nOn the\xa0CardioNerds Myocarditis page\xa0you will find podcast episodes,\xa0infographic,\xa0youtube videos,\xa0references,\xa0tweetorials\xa0and\xa0guest experts & contributors,\xa0flutter stars\xa0and so much more.\n\n\n\n\n\n\n\nTake me to the Myocarditis Series PageTake me to the episode topics pagesCheck out Amit Goyal\u2019s Myocarditis Tweetorial\n\n\n\n5 points of maximal impulse in approaching myocarditis (review from episode 31)\n\n\n\nBuild the clinical suspicion for myocarditis: You need a high index of suspicion given the variable presentation, and definitely need to keep a differential so you don\u2019t miss things like acute coronary syndromes.Decide if EMBx is necessary: Most often obtained in fulminant presentations to look for pathologic findings of giant cell myocarditis or eosinophilic myocarditis, because these findings will change management.Manage the acute cardiac injury, which can range from supportive care to treatment of shock, arrhythmias, and even tamponade.Manage the chronic cardiac sequelae:\xa0Recovering from the acute phase of myocarditis doesn\u2019t necessarily mean smooth sailing \u2014 some develop chronic heart failure, warranting GDMT \u2014 or guideline directed\xa0management\xa0and therapy, as defined byDr. Randall Starling in Ep 13.Treat the myocarditis: Immunosuppression is often started empirically in fulminant disease, but continuation depends on what you find on pathology.