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Case Reports in Cardiology
Volume 2015, Article ID 173826, 4 pages
http://dx.doi.org/10.1155/2015/173826
Case Report

Giant Cell Myocarditis: Not Always a Presentation of Cardiogenic Shock

1Department of Cardiology, New York University Langone Medical Center, New York, NY 10016, USA
2Department of Radiology, New York University School of Medicine, New York, NY 10016, USA

Received 7 March 2015; Accepted 2 July 2015

Academic Editor: Gianluca Pontone

Copyright © 2015 Rose Tompkins et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.