Recovery from complete atrioventricular block caused by idiopathic giant cell myocarditis after corticosteroid therapy.
Giant cell myocarditis (GCM) is a rapidly progressive disease that leads to ventricular tachycardia or high-grade atrioventricular (A-V) block, frequently requiring a pacemaker. A 64-year-old woman developed syncope as a result of idiopathic GCM with A-V block. She required both a temporary and a permanent pacemaker. Two-dimensional echocardiography showed severely reduced wall motion. There was no histologic or clinical evidence to suggest sarcoidosis. Despite treatment with diuretics and an angiotensin-converting enzyme inhibitor, exertional dyspnea persisted. She received prednisolone 4 months after the onset of complete A-V block in the late phase of GCM. Prednisolone improved A-V nodal conduction in spite of the fact that there was no influence from LV wall motion, and sinus rhythm has continued for more than 2 years. In this patient, prednisolone was effective in the treatment of GCM.
Hanawa
H
H
First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi, Japan.
Izumi
T
T
Saito
Y
Y
Ochiai
Y
Y
Okura
Y
Y
Inomata
T
T
Hirono
S
S
Ogawa
Y
Y
Saito
R
R
Kodama
M
M
Higuma
N
N
Aizawa
Y
Y
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D004452:Echocardiography; D005260:Female; D015726:Giant Cells; D006327:Heart Block / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D011239:Prednisolone / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D011239:Prednisolone