Acute myocardial interstitial edema from pathophysiology to therapeutic considerations in critical care: a narrative review

Abstract

The excess accumulation of fluid in the extracellular space of the heart determines a condition of “myocardial interstitial edema.” Myocardial edema is present in multiple pathological conditions observed in the intensive care setting: fulminant myocarditis, sepsis-induced cardiomyopathy, cardiac arrest, capillary leak syndrome, and extracorporeal circulation. Fluid accumulation in the interstitium can occur rapidly, leading to severe heart failure and potentially progressing to cardiogenic shock. Early diagnosis and prompt therapy are crucial. Understanding the factors and diseases that can disrupt myocardial fluid homeostasis and contribute to the development of interstitial edema allows for a targeted therapeutic approach, aimed at reducing fluid accumulation and clinical detrimental effects.

Keywords

Cardiac arrest / Cardiogenic shock / Fulminant myocarditis / Myocardial fluid balance / Myocardial interstitial edema / Sepsis-induced cardiomyopathy / Systemic capillary leak syndrome

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