LAUSR

F ulminant myocarditis (FM) is characterized by acute cardiac inflammation that presents suddenly (<2-week symptom duration), can lead to cardiogenic shock and electrical instability, and requires inotropic or mechanical circulatory support. An initial publication suggested that patients with FM had better outcomes than patients with acute nonfulminant myocarditis (NFM) (1). This paradoxical result was challenged by a contemporary study of patients with acute myocarditis where FM led to a greater rate of in-hospital death or transplantation and lower long-term survival compared with NFM (2).