Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell Myocarditis
Background. Idiopathic giant cell myocarditis (GCM) has a fulminant course and typically presents in middle-aged adults with acute heart failure or ventricular arrhythmia. It is a rare disorder which involves T lymphocyte-mediated myocardial inflammation. Diagnosis is challenging and requires a high...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/7276516 |
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| author | Michael H. Chiu Cvetan Trpkov Saman Rezazedeh Derek S. Chew |
| author_facet | Michael H. Chiu Cvetan Trpkov Saman Rezazedeh Derek S. Chew |
| author_sort | Michael H. Chiu |
| collection | DOAJ |
| description | Background. Idiopathic giant cell myocarditis (GCM) has a fulminant course and typically presents in middle-aged adults with acute heart failure or ventricular arrhythmia. It is a rare disorder which involves T lymphocyte-mediated myocardial inflammation. Diagnosis is challenging and requires a high index of suspicion since therapy may improve an otherwise uniformly fatal prognosis. Case Summary. A previously healthy 54-year-old female presented with hemodynamically significant ventricular arrhythmia (VA) and was found to have severe left ventricular dysfunction. Cardiac MRI demonstrated acute myocarditis, and endomyocardial biopsy showed giant cell myocarditis. She was treated with combined immunosuppressive therapy as well as guideline-directed medical therapy. A secondary prevention implantable cardioverter defibrillator (ICD) was implanted. Discussion. GCM is a rare, lethal myocarditis subtype but is potentially treatable. Combined immunosuppression may achieve partial clinical remission in two-thirds of patients. VA is common, and patients should undergo ICD implantation. More research is needed to better understand this complex disease. Learning Objectives. Giant cell myocarditis is an incompletely understood, rare cause of myocarditis. Patients present predominately with heart failure and dysrhythmia. Diagnosis is confirmed by histopathology, and immunosuppression may improve outcomes. ICD implantation should be considered. In the absence of treatment, prognosis is poor with a median survival of three months. |
| format | Article |
| id | doaj-art-275b917c90e64155ac83f56338595460 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-275b917c90e64155ac83f563385954602025-02-03T01:32:44ZengWileyCase Reports in Cardiology2090-64042090-64122019-01-01201910.1155/2019/72765167276516Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell MyocarditisMichael H. Chiu0Cvetan Trpkov1Saman Rezazedeh2Derek S. Chew3Libin Cardiovascular Institute of Alberta, Cummings School of Medicine, University of Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, Cummings School of Medicine, University of Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, Cummings School of Medicine, University of Calgary, Alberta, CanadaLibin Cardiovascular Institute of Alberta, Cummings School of Medicine, University of Calgary, Alberta, CanadaBackground. Idiopathic giant cell myocarditis (GCM) has a fulminant course and typically presents in middle-aged adults with acute heart failure or ventricular arrhythmia. It is a rare disorder which involves T lymphocyte-mediated myocardial inflammation. Diagnosis is challenging and requires a high index of suspicion since therapy may improve an otherwise uniformly fatal prognosis. Case Summary. A previously healthy 54-year-old female presented with hemodynamically significant ventricular arrhythmia (VA) and was found to have severe left ventricular dysfunction. Cardiac MRI demonstrated acute myocarditis, and endomyocardial biopsy showed giant cell myocarditis. She was treated with combined immunosuppressive therapy as well as guideline-directed medical therapy. A secondary prevention implantable cardioverter defibrillator (ICD) was implanted. Discussion. GCM is a rare, lethal myocarditis subtype but is potentially treatable. Combined immunosuppression may achieve partial clinical remission in two-thirds of patients. VA is common, and patients should undergo ICD implantation. More research is needed to better understand this complex disease. Learning Objectives. Giant cell myocarditis is an incompletely understood, rare cause of myocarditis. Patients present predominately with heart failure and dysrhythmia. Diagnosis is confirmed by histopathology, and immunosuppression may improve outcomes. ICD implantation should be considered. In the absence of treatment, prognosis is poor with a median survival of three months.http://dx.doi.org/10.1155/2019/7276516 |
| spellingShingle | Michael H. Chiu Cvetan Trpkov Saman Rezazedeh Derek S. Chew Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell Myocarditis Case Reports in Cardiology |
| title | Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell Myocarditis |
| title_full | Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell Myocarditis |
| title_fullStr | Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell Myocarditis |
| title_full_unstemmed | Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell Myocarditis |
| title_short | Monomorphic Ventricular Tachycardia as a Presentation of Giant Cell Myocarditis |
| title_sort | monomorphic ventricular tachycardia as a presentation of giant cell myocarditis |
| url | http://dx.doi.org/10.1155/2019/7276516 |
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