A 42 year-old female with fulminant myocarditis became acutely ill following a distinct viral prodrome 2 weeksbefore her hospitalization. She had severe ventricular dysfunction and multiple foci of giant cell myocarditis on thehistopathological study. She experienced severe hemodynamic compromise that required high-dose vasopressors,immunoglobulin and extracorporeal membrane oxygenation (ECMO). Although she was managed with aggressivepharmacologic and mechanical support and also heart transplantation, she died at hospital day 12. (KoreanCirculation J 2006;36:159-161)