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Giant Cell and Hypersensitivity Myocarditis

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Myocarditis

Abstract

Giant cell myocarditis (GCM) and hypersensitivity myocarditis (HSM) are both rare inflammatory diseases of the myocardium that are rapidly progressive and carry poor prognosis. Histologically both diseases have eosinophilic infiltration but in the case of HSM the infiltration is predominantly in the perivascular area. GCM is characterized by the presence of giant cells and necrosis. Patients affected by these forms of myocarditis tend to present with heart failure symptoms and ventricular arrhythmias. Endomyocardial biopsy is highly sensitive for the diagnosis of GCM, while in the case of HSM it may aid in the diagnosis but sensitivities have not been reported. Initiation of immunosuppressive therapies along with guideline directed heart failure therapy improves survival in patients with GCM. In the case of HSM, withdrawal of the offending agent along with heart failure therapies allows for myocardial recovery. In some instances patients are hemodynamically unstable and require mechanical circulatory support as a bridge to recovery or as a bridge to transplant. Survival post-transplant for GCM is similar to other forms of cardiomyopathy.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Mayo Clinic in Florida, Jacksonville, FL, USA

    Yahaira Ortiz Gonzalez & Leslie T. Cooper

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  1. Yahaira Ortiz Gonzalez
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Correspondence to Leslie T. Cooper .

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  1. Cardiology, Department of Cardiac Thoracic Vascular Science and Public Health, University of Padova, Policlinico Universitario, Padova, Italy

    Alida L. P. Caforio

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Gonzalez, Y.O., Cooper, L.T. (2020). Giant Cell and Hypersensitivity Myocarditis. In: Caforio, A. (eds) Myocarditis. Springer, Cham. https://doi.org/10.1007/978-3-030-35276-9_12

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  • DOI: https://doi.org/10.1007/978-3-030-35276-9_12

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