title: Serial right ventricular endomyocardial biopsy in rapid-onset severe heart failure due to giant cell myocarditis.
abstract: Giant cell myocarditis (GCM) is a serious condition that warrants immediate diagnosis and treatment. It often presents as rapidly progressive heart failure and/or malignant ventricular arrhythmias. Here, we describe a 34-year-old patient with myasthenia gravis who presented with GCM 2 weeks after resection of a thymoma. A cardiac biopsy confirming the diagnosis was done within 3 days after admission. After institution of an aggressive immunosuppressive drug regimen, implantation of an implantable cardioverter defibrillator, and intensive cardiac rehabilitation, the patient recovered dramatically. In control biopsies after 4 weeks and 6 months, no more giant cells were found. We conclude that, in the case of nonischemic acute heart failure in young patients, a biopsy should be performed as soon as possible to prevent an unfavourable outcome of this often fatal disease.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, NL-9700RB Groningen, The Netherlands. p.l.van.haelst@thorax.umcg.nl
authors.forename: Paul L
authors.initials: PL
authors.lastname: van Haelst
authors.forename: Johan
authors.initials: J
authors.lastname: Brügemann
authors.forename: Gilles F
authors.initials: GF
authors.lastname: Diercks
authors.forename: Albert
authors.initials: A
authors.lastname: Suurmeijer
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D000208:Acute Disease; D000328:Adult; D001706:Biopsy / Q000379:methods; D002303:Cardiac Output, Low / Q000209:etiology / Q000473:pathology*; D004699:Endocardium / Q000473:pathology*; D015726:Giant Cells / Q000473:pathology*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000473:pathology