Not every fulminant lymphocytic myocarditis fully recovers

Fulminant myocarditis is a distinct entity within the acute forms of myocarditis characterized by a rapidly progressive clinical course. Lymphocytic forms have been historically reported to generally resolve spontaneously with early appropriate aggressive supportive care alone. We describe the case of a 28-year-old man with lymphocytic fulminant myocarditis presenting with out-of-hospital cardiac arrest, treated with veno-arterial extracorporeal membrane oxygenation, progressed to end stage cardiac failure requiring heart transplantation. In line with recent evidence, we highlight the need for prolonged supportive treatment and the eventual persistent long-term ventricular dysfunction in patients with fulminant myocarditis