0148: Characteristics and clinical outcome of patients admitted in the intensive care unit for acute myocarditis

IntroductionAlthough myocarditis is increasingly recognized in clinical practice, the characteristics and prognosis of patients with suspected myocarditis are poorly defined. Therefore, the aim of this study was to describe the characteristics and clinical outcome of patients admitted to a university hospital for acute myocarditis.MethodsRetrospective study of patients admitted to the cardiology intensive care unit of a university hospital between January 2009 and March 2014 with a discharge diagnosis of myocarditis. Patients with suspected acute coronary syndrome (ACS) underwent either coronary angiography or coronary computed tomography angiography (CCTA). Clinical follow-up was obtained by phone call to the referring physician.ResultsDuring the study period, 84 patients (mean age 37±14 years old, 83% males) were admitted for myocarditis. 54% of admissions occurred between November and February. A chest pain was present in 93% of Pts and 35.7% of Pts had fever in the preceding month. In 38.1% of Pts, ECG was suggestive of ACS whereas diffuse ST elevation was found in 26.2% of Pts and a normal ECG in 23.8%. A pericardial effusion was found in 31.3% of Pts. Mean ejection fraction was 59.6±8.8%. Peak Troponin was 657±704ng/l. CRP was increased in 75.3%. A cardiac MRI was performed in 90.5% of cases and a coronary angiography in 47.6% of cases. No endomyocardial biopsy was performed. An infectious aetiology was found in 47.6% of cases. Treatment included aspirin (87.5%), beta-blockers (66.5%), and ACE inhibitors (42.9%). There was no death during hospital stay. At a mean follow-up of 28±20 months, 2 Pts (2.6%) died from non-cardiac causes and recurrences occurred in only 5.3% of Pts. Mean ejection fraction was 62.1±5.3%.ConclusionPatients admitted in a cardiology intensive care unit for acute myocarditis are mostly young males and a large part of admissions occurs during winter. In-hospital and mid-term outcome is good