Giant Cell Myocarditis (GCM) is a rare autoimmune myocarditis that tends to affect a young or middle-aged adult. It is often fatal or requires heart transplant.
Mechanism: autoimmune, possibly mediated by T-cells
Clinical features:
(1) sudden onset of heart failure
(2) poor response to standard therapy
(3) variable angina
(4) cardiomegaly with ventricular dilatation
ECG changes may include:
(1) conduction system abnormalities
(2) ventricular arrhythmias
A heart biopsy shows the presence of chronic inflammation with giant cells, lymphocytes and eosinophils.
Some patients may have:
(1) Wegener's granulomatosis or other autoimmune disease
(2) thymoma
Exclusions:
(1) tuberculosis or other mycobacterial diseases
(2) sarcoidosis
(3) fulminant lymphocytic myocarditis
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