कार्डियोजेनिक शॉक या तेजी से प्रगतिशील रोग के साथ कार्डियक सारकॉइडोसिस — जब प्रारंभिक कॉर्टिकोस्टेरॉइड चिकित्सा से रोग नियंत्रण प्राप्त नहीं हुआ

For those with life-threatening manifestations such as cardiogenic shock, higher initial corticosteroid doses, including intravenous doses of methylprednisolone of up to 1000 mg/d, can be prescribed until other causes of acute myocarditis (such as giant-cell myocarditis) are excluded.

In a tiered approach to treatment (Figure 3), individuals with relapse or ongoing inflammation after corticosteroids would receive a second-line agent (methotrexate, mycophenolate, azathioprine, or leflunomide) in combination with corticosteroids.

DOI: 10.1161/CIR.0000000000001240