title: Giant Cell Myocarditis: Not Always a Presentation of Cardiogenic Shock.
abstract: Giant cell myocarditis is a rare and often fatal disease. The most obvious presentation often described in the literature is one of rapid hemodynamic deterioration due to cardiogenic shock necessitating urgent consideration of mechanical circulatory support and heart transplantation. We present the case of a 60-year-old man whose initial presentation was consistent with myopericarditis but who went on to develop a rapid decline in left ventricular systolic function without overt hemodynamic compromise or dramatic symptomatology. Giant cell myocarditis was confirmed via endomyocardial biopsy. Combined immunosuppression with corticosteroids and calcineurin inhibitor resulted in resolution of symptoms and sustained recovery of left ventricular function one year later. Our case highlights that giant cell myocarditis does not always present with cardiogenic shock and should be considered in the evaluation of new onset cardiomyopathy of uncertain etiology as a timely diagnosis has distinct clinical implications on management and prognosis.
authors.affiliation: Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: Rose
authors.initials: R
authors.lastname: Tompkins
authors.affiliation: Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Cole
authors.affiliation: Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: Barry P
authors.initials: BP
authors.lastname: Rosenzweig
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, NY 10016, USA.
authors.forename: Leon
authors.initials: L
authors.lastname: Axel
authors.affiliation: Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: Sripal
authors.initials: S
authors.lastname: Bangalore
authors.affiliation: Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, USA.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Lala