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Giant cell myocarditis in an older patient – reassessing the threshold for endomyocardial biopsy
Author(s) -
Dusík Milan,
Daud Anees,
Šmíd Ondřej,
Havránek Štěpán,
Vítková Ivana,
Revelo Monica Patricia,
Stehlik Josef,
Linhart Aleš,
Bělohlávek Jan
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12756
Subject(s) - medicine , myocarditis , heart failure , immunosuppression , cardiology , endomyocardial biopsy , biopsy
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.