Rapid recovery from acute myocarditis under levosimendan treatment: report of two cases
Article first published online: 26 FEB 2013
© 2013 Blackwell Publishing Ltd
Journal of Clinical Pharmacy and Therapeutics
Volume 38, Issue 2, pages 179–180, April 2013
How to Cite
Ercan, S., Davutoglu, V., Cakici, M., Kus, E., Alici, H. and Sari, I. (2013), Rapid recovery from acute myocarditis under levosimendan treatment: report of two cases. Journal of Clinical Pharmacy and Therapeutics, 38: 179–180. doi: 10.1111/jcpt.12038
- Issue published online: 7 MAR 2013
- Article first published online: 26 FEB 2013
- Manuscript Accepted: 5 DEC 2012
- Manuscript Received: 9 APR 2012
- acute myocarditis;
- ejection fraction;
- global hypokinesia;
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 μg/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 μg/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.