Key Treatment Interventions in the ED

The following table outlines the key treatment interventions in the ED for patients with suspected acute myocarditis.

Management goal	Intervention
Airway protection	Endotracheal intubation may be required in some patients
Ensure adequate oxygenation	Supplemental oxygen therapy Non-invasive ventilation or CPAP Mechanical ventilatory support
Maintenance of adequate perfusion	Invasive monitoring Cautious fluid bolus Inotropic and vasopressor support
Treatment of pulmonary oedema	Diuretics Nitrates ACE inhibitors CPAP
Control of arrhythmias	Antiarrhythmics Correction of electrolyte disturbances
Reduce metabolic demands	Bed rest Fever reduction Blood sugar control Treat intercurrent infection Correct anaemia

Learning-bite

Treatment of myocarditis is largely supportive and this may involve aggressive cardiorespiratory resuscitation in the ED.