Fulminant Myocarditis in a Child Requiring Extracorporeal Cardiopulmonary Resuscitation: A Case Report

Area of Science:

• Pediatric Cardiology
• Emergency Medicine
• Critical Care

Background:

• Extracorporeal cardiopulmonary resuscitation (ECPR) use in pediatric out-of-hospital cardiac arrest (OHCA) is limited, with insufficient evidence.
• Accumulating case data is crucial for establishing best practices in pediatric OHCA management.

Observation:

• A previously healthy 10-year-old girl experienced sudden cardiac arrest and ventricular tachycardia (VT).
• ECPR was initiated in the emergency department due to persistent VT after defibrillation.
• Clinical presentation included symptoms of a common cold, rapid circulatory failure, and specific echocardiographic, ECG, and laboratory findings.

Findings:

• The patient was diagnosed with fulminant myocarditis based on clinical, echocardiographic, ECG, and hematologic data.
• Successful ECPR was performed, leading to the patient's recovery.
• The patient was discharged on hospital day 25 with no neurological deficits.

Implications:

• This case underscores the potential efficacy of ECPR in select pediatric OHCA cases, particularly those with fulminant myocarditis.
• Further research and data collection are warranted to define the role of ECPR in pediatric cardiac arrest.
• Successful ECPR can lead to favorable outcomes in critically ill pediatric patients, even after OHCA.