Tropical Myocarditis Severity Index (TMSI) – Resource-Limited Adaptation

Tropical Myocarditis Severity Index (TMSI) – Resource-Limited Adaptation Tropical Myocarditis Severity Index (TMSI): Explanation and Clinical Context The Tropical Myocarditis Severity Index (TMSI) is a pragmatic bedside score tailored for use in tropical, resource-limited healthcare settings where myocarditis frequently presents secondary to infections such as dengue, rickettsioses, Chagas disease, and leptospirosis. The index prioritizes clinically accessible variables—hemodynamics, arrhythmias, and basic laboratory surrogates—to stratify patients into low, intermediate, or high-risk categories at the point of care. The Enhanced version integrates echocardiographic LVEF, serum lactate, and vasoactive support, mirroring prognostic markers recognized in fulminant myocarditis cohorts.

High-risk scores correspond to presentations with circulatory failure, malignant ventricular arrhythmias, or end-organ dysfunction—features associated with adverse outcomes and higher mortality.