Successful Recovery in Fulminant Viral Myocarditis Using ECPR: A Case Report

BackgroundFulminant myocarditis is a rare but life-threatening condition characterized by sudden onset of severe myocardial inflammation leading to cardiogenic shock and arrhythmias.Without prompt and aggressive intervention, it often results in poor outcomes. Case summaryWe report a case of a 40-year-old female who presented in refractory cardiogenic shock secondary to suspected fulminant viral myocarditis.She experienced a witnessed inhospital cardiac arrest due to pulseless ventricular tachycardia.Extracorporeal cardiopulmonary resuscitation (ECPR) was promptly initiated using veno-arterial extracorporeal membrane oxygenation (V-A ECMO).Return of spontaneous circulation (ROSC) was achieved, and post-arrest care revealed intact neurological function.She was managed on V-A ECMO and weaned successfully by day 12.Her hospital course was complicated by right-sided hemothorax requiring interventional radiology and thoracic surgery.After a prolonged but successful recovery, she was discharged with good clinical and functional status. ConclusionThis case highlights the potential for favorable outcomes in fulminant myocarditis through early implementation of ECPR , emphasizing the value of advanced life-support strategies in refractory cardiac arrest scenarios.