Acute myocardial interstitial edema from physiopathology to therapeutic implications in critical care setting: a narrative review

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.