Department of Pharmacy, Cleveland Clinic, Cleveland, OH.
Division of Cardiology, University of Florida Health, Gainesville, FL, USA.
ESC Heart Fail. 2020 Feb;7(1):315-319. doi: 10.1002/ehf2.12564. Epub 2019 Dec 24.
Giant cell myocarditis is a rare but often devastating diagnosis. Advances in cardiac imaging and mechanical circulatory support have led to earlier and more frequent diagnoses and successful management. This disease state has wide variation in acuity of presentation, and consequently, optimal treatment ranging from intensity and type of immunosuppression to mechanical circulatory support is not well defined. The following case describes the management of a patient with an unusual presentation of giant cell myocarditis over a 10 year course of advanced heart failure therapies and immunomodulatory support. This case highlights emerging concepts in the management of giant cell myocarditis including sub-acute presentations, challenges in diagnosis, and treatment modalities in the modern era.
巨细胞心肌炎是一种罕见但常常是致命的诊断。心脏成像和机械循环支持的进步导致了更早和更频繁的诊断和成功的管理。这种疾病状态在表现的严重程度上有很大的差异，因此，从免疫抑制的强度和类型到机械循环支持的最佳治疗方法并没有很好地确定。以下病例描述了一名患者在 10 年的晚期心力衰竭治疗和免疫调节支持过程中出现不寻常的巨细胞心肌炎表现的治疗情况。这个病例强调了巨细胞心肌炎管理中的一些新出现的概念，包括亚急性表现、诊断方面的挑战以及现代治疗方式。
