21-year-old female myocarditis expert points out that it is surprising that she can heal herself until the worst

The young woman who had no long-term illness or a history of heart disease died suddenly from myocarditis. The cause of death today (18th) continues to be inquired about her death.

Cardiologists pointed out that the main treatment for myocarditis is supportive treatment. As long as "the worst moment can be held", the patient has a chance to heal on their own.

However, the mortality rate of acute myocarditis is also as high as 1 in 4. The patient in this inquiry has a sharp deterioration in her condition. It is surprising. Even if she can be found to have myocarditis in time, it is still uncertain whether the result can be reversed. Experts also It is believed that the hospital's treatment at that time was appropriate.

The deceased Su Jieyin (aged 21) went to the Accident and Emergency Department of Princess Margaret Hospital on January 4, 2017 due to heartache and other conditions. She had suffered from an upper respiratory tract infection before about one star.

However, her condition had deteriorated the night she was admitted, and she remained in the hospital for 3 weeks until she died on the 26th of the same month.

Myocarditis has no unique clinical features

Tan Leren, a consultant cardiologist at the Tuen Mun Hospital, gave evidence today as an expert witness. Tan pointed out that myocarditis has no unique and guiding clinical signs, and its symptoms are likely to appear in other diseases.

Although Su’s symptoms when he went to the emergency department for treatment were consistent with myocarditis, it was still difficult for doctors to make a judgment on myocarditis.

Confession of the main witness.

(See the picture below for details)

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The data shows that Su had heart damage at the time

When Su was admitted to the hospital for multiple examinations, his blood report was acidic, indicating that the body's blood circulatory system function has declined, and heart failure may have occurred. The doctor may consider performing examinations such as electrocardiogram, electrocardiogram ultrasound, and heart rhythm monitoring to be more alert to changes in the heart condition. Tick.

Another report showed that Su's troponin reached 775, which was higher than normal, indicating that his heart was damaged.

Tan pointed out that it is worth considering heart examinations and monitoring Su's blood pressure and heartbeat more frequently.

Wei Tan emphasized that based on the information he had at the time, the hospital's handling methods were understandable.

Su has no special medical history or drug abuse

Tan further explained that Su had several cardiac arrests, resulting in hypoxia in his organs. Troponin increased from 775 to more than 39,000 at first, and then as high as 86,000, which clearly indicated that his heart was damaged.

Su is a young patient with no special medical history and no drug abuse. When his troponin rises to such a high level, his chance of suffering from myocarditis is very high.

Transferred to the intensive care department and received antibiotics and other treatments

Su was later transferred to the intensive care department on January 5, and his lungs, respiratory system, kidneys, etc. had organ failure, and his brain edema further deteriorated. The hospital used cardiotonic drugs, antibiotics, heart-lung machines, ventilator and kidney dialysis for him. Tan described the hospital's prescription as "appropriate treatment."

Defending the worst moment will significantly improve

When it comes to the treatment of myocarditis, Tan pointed out that the main force is supportive treatment to maintain its physical function, and most of myocarditis can be cured on its own. Tan said: "Don’t stay in the wild, I will support it... Live the worst moment, there will be a noticeable improvement."

Acute myocarditis mortality rate is as high as 1 in 4

Tan You pointed out that the mortality rate of acute myocarditis is also as high as 1 in 4.

As for Su's situation at that time, although his heart once showed signs of recovery, his brain did not recover, and antibiotics can only target pneumonia, not the virus, so it will not play a decisive role in myocarditis.

Su's condition deteriorated sharply and surprisingly

Tan concluded by saying that Suyin virus caused fulminant myocarditis, leading to sudden death. During this period, she had cardiac arrest, which caused multiple organ failures and other complications.

Moreover, the sudden change in Su’s condition was surprising. It took only 12 hours from admission to cardiac arrest, and it was so fast that it was difficult to stop.

Tan You believes that even if the hospital strengthened supervision and found that his troponin had risen sharply, he could not predict whether he could stop his heart from stopping.

Case Number: CCDI-89/2017

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