Doctor Pham Phong Luan, from the Cardiology Department at the Heart Center, Tam Anh General Hospital, Ho Chi Minh City, stated that the patient presented with significantly elevated cardiac enzymes and a slightly reduced ejection fraction (EF), confirming acute myocarditis. This condition involves inflammation of all or part of the heart muscle. The most common causes are viral infections, such as influenza virus, hepatitis B and C viruses, and herpes virus. It can also result from bacterial, parasitic, or fungal infections, or adverse drug reactions.

Despite vague chest pain, Van showed no fever, cough, or other signs of infection. Tests confirmed she had no viral or bacterial infection. "It was not possible to precisely identify the cause of the patient's acute myocarditis, but a rare side effect after taking deworming medication is a possibility," said Doctor Luan. Acute myocarditis can progress rapidly, leading to severe heart failure, dangerous arrhythmias, and even sudden cardiac arrest.

The patient received intensive care in the ICU. Photo: Tam Anh General Hospital

Within hours, the patient's heart function rapidly declined, blood pressure dropped sharply, and slow arrhythmias appeared. According to Doctor Dang Le Hong Ngan from the Cardiovascular Surgery Intensive Care Unit, Intensive Care and Anti-poisoning Department (ICU) at Tam Anh General Hospital, HCMC, Van's heart was severely weakened by an "inflammatory storm." In less than 48 hours, her heart's ejection fraction was only about 20%, insufficient to maintain circulation. The medical team intubated her and initiated VA-ECMO, an artificial heart-lung machine, along with a temporary pacemaker, to temporarily support her heart and lung functions.

After three days of intensive treatment, Van's heart rate stabilized, and she was gradually weaned off ECMO. She was extubated, and her EF increased to over 50%. Her heart failure treatment continued with beta-blockers, diuretics, SGLT2 inhibitors, and anticoagulants. She was discharged after three weeks.

Doctor Luan examining the patient before discharge. Photo: Ha Vu

Doctor Luan explained that myocarditis can affect people of all ages, but it is more common in young adults aged 20-40. Many cases present with subtle symptoms or almost no warning signs. Common symptoms include: chest pain, shortness of breath on exertion, rapid heartbeat, fatigue, muscle aches, headache, runny nose, diarrhea, or poor appetite. In severe cases, patients may develop cardiogenic shock, low blood pressure, dangerous arrhythmias, or multi-organ failure.

To minimize the risk of myocarditis, individuals should practice good personal hygiene, prevent viral infections, especially influenza, and ensure they receive all recommended vaccinations.

Thu Ha - Nhat Ngo

*Patient's name has been changed