Mr. LVH (32 years old, Binh Dong, Ho Chi Minh City) played badminton as usual at the training center in An Khanh Dong, Ho Chi Minh City with some colleagues. While playing badminton for about 30 minutes, Mr. H suddenly felt nervous, dizzy, had difficulty breathing, and severe pain in his chest, and quickly lost consciousness. Mr. H was immediately taken to the nearest hospital by his friends who played badminton with him.
When he arrived at the hospital, Mr. H was unconscious, unconscious, and his circulation had stopped. Immediately, Mr. H was diagnosed with ventricular arrhythmia, his cardiopulmonary recovery was restored, and a red alert was issued between Gia Dinh People’s Hospital and the hospital.
Fifteen minutes later, Mr. H was taken to the emergency room of Gia Dinh People’s Hospital, prepared by the cardiovascular intensive care unit ECMO (adventitious blood oxygenation) team. Upon admission, Mr. H underwent VA ECMO emergency intensive care unit (arterial-venous method epicardial blood oxygenation) intervention with ventricular arrhythmia intensive care unit.
After his circulation was stabilized, Mr. H underwent whole-body computed tomography to rule out common causes of sudden cardiac death such as acute myocardial infarction, pulmonary embolism, or acute aortic disease.
Forty-eight hours after deep cardiac arrest with VA ECMO, thermoregulation, use of high-dose corticosteroids for suspected viral acute myocarditis, and continuous hemodialysis, Mr. H regained full consciousness, no longer had ventricular arrhythmias, cardiac function recovered, and VA ECMO was discontinued.
After 7 days of hospitalization, Mr. H’s functional status is now almost completely stable and he can be discharged. As a result of the cardiac MRI, it was confirmed that Mr. H had acute inflammation in the myocardium and pericardium.
Delighted after his recovery, Mr. H said, “When you play sports, if you see signs of fatigue or pain, you should stop and go to the hospital to get checked out. You shouldn’t try too hard and you shouldn’t be careless about your health.”
“Viral acute myocarditis is common in cold weather and rainy seasons in Vietnam, and common symptoms such as colds and gastroenteritis often catch patients, especially young people, off guard,” said Bo Van Trang, MS-Doctor, Cardiovascular Intensive Care Unit, Gia Dinh People’s Hospital.
In addition to respiratory or gastrointestinal symptoms, patients with acute myocarditis also present with cardiovascular symptoms, including chest pain (>80% of patients), shortness of breath (20-50% of patients), and palpitations. If not detected and treated in a timely manner, a small number of patients with acute myocarditis may develop acute myocarditis caused by cardiac arrhythmia and hypotension due to weakened myocardial contractility, and most cases of acute myocarditis can be quickly recovered after one week with timely and appropriate mechanical circulatory support intervention.
However, Nguyen Thanh Thao, MS-Doctor, from the Cardiovascular Intensive Care Unit at Gia Dinh People’s Hospital, said not all patients with acute myocarditis caused by viruses are as lucky as the case of Mr H, who was found to have died suddenly and received emergency treatment quickly thanks to close cooperation between hospitals.
Because of the nature of inflammation that spreads to the myocardium as demonstrated by cardiac resonance, patients should be closely monitored and screened for cardiomyopathy gene mutations and undergo myocardial biopsy if persistent myocarditis develops. Patients should also limit their efforts during the first 3 months to avoid the risk of sudden death and recurrent arrhythmias.
