Giant cell myocarditis in an older patient - reassessing the threshold for endomyocardial biopsy

ESC Heart Fail. 2020 Oct;7(5):3165-3168. doi: 10.1002/ehf2.12756. Epub 2020 Jul 9.

Abstract

Giant cell myocarditis is a rare form of autoimmune myocarditis with high morbidity and mortality that affects mainly middle-aged adults. We report a case study of a 70-year-old man on chronic immunosuppression who presented with sustained ventricular tachycardia and symptoms of acute systolic heart failure, both with poor response to standard measures. A decision to pursue endomyocardial biopsy established the diagnosis of GCM and lead to initiation of immunosuppressive therapy and a favourable outcome. Our case illustrates that a low threshold for endomyocardial biopsy in new onset heart failure can lead to actionable information even in patients of advanced age.

Keywords: Endomyocardial biopsy; Giant cell myocarditis; Heart failure; Immunosuppressive treatment; Inflammatory heart disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Giant Cells
  • Heart Failure* / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Myocarditis* / diagnosis
  • Myocardium