title: Giant cell myocarditis: a life-threatening disorder heralded by orbital myositis.
abstract: A 40-year-old man with a history of orbital myositis (OM) presented to the emergency department with ventricular tachycardia requiring electrical cardioversion. Postcardioversion ECG showed right bundle branch block, while an echocardiogram revealed an ejection fraction of 20% and a dilated right ventricle. Cardiac MRI produced suboptimal images because the patient was having frequent arrhythmias. The rest of the work up, including coronary angiography, was unremarkable. Given the dilated right ventricle, we suspected arrhythmogenic right ventricular cardiomyopathy and discharged the patient with an implantable cardioverter-defibrillator. 1 week later, he was readmitted with cardiogenic shock; endomyocardial biopsy revealed giant cell myocarditis (GCM). To the best of our knowledge, this is the seventh case report of GCM described in a patient with OM. We recommend that clinicians maintain a high degree of suspicion for GCM in patients with OM presenting with cardiac problems.
authors.affiliation: Department of Medicine, John H Stroger, Jr, Hospital of Cook County, Chicago, Illinois, USA.
authors.forename: Muhammad Sajawal
authors.initials: MS
authors.lastname: Ali
authors.affiliation: Department of Medicine, John H Stroger, Jr, Hospital of Cook County, Chicago, Illinois, USA.
authors.forename: Benjamin I
authors.initials: BI
authors.lastname: Mba
authors.affiliation: Department of Pathology, University of Chicago, Chicago, USA.
authors.forename: Aliya Noor
authors.initials: AN
authors.lastname: Husain
authors.affiliation: Department of Medicine, John H Stroger, Jr, Hospital of Cook County, Chicago, Illinois, USA.
authors.forename: Farah Diba
authors.initials: FD
authors.lastname: Ciftci
mesh_terms: D000328:Adult; D001706:Biopsy; D017147:Defibrillators, Implantable; D004452:Echocardiography; D004562:Electrocardiography; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications* / Q000175:diagnosis; D055622:Orbital Myositis / Q000150:complications* / Q000175:diagnosis; D012008:Recurrence; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000628:therapy