Pham Lily A, Chung Joseph, Gavaghan Callan
School of Medicine, The University of Queensland, Brisbane, QLD 4102, Australia.
Department of Cardiology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
Eur Heart J Case Rep. 2022 Jul 11;6(7):ytac269. doi: 10.1093/ehjcr/ytac269. eCollection 2022 Jul.
Giant cell myocarditis (GCM) is a rare and rapidly progressive disease associated with significant morbidity and mortality. Whilst patients more frequently present with acute heart failure, diagnosis is difficult due to heterogeneity in clinical presentations.
This case report presents a previously healthy 59-year-old Vietnamese woman who initially presented with syncope and a motor vehicle accident who developed rapid decline in left ventricular function. Her initial echocardiogram was suggestive of an infiltrative cardiomyopathy. GCM was confirmed on biopsy, and she received combined immunosuppression. Twenty-seven days following her initial presentation to hospital, she was unable to recover from severe multi-organ dysfunction, and the patient was palliated and passed away.
This case highlights the varied manner in which GCM may present. Even in the absence of cardiogenic shock at presentation, giant cell myocarditis should be considered in the evaluation of new cardiomyopathy of uncertainty aetiology. Diagnosis of this condition has distinct clinical implications on management and prognosis.
巨细胞性心肌炎（GCM）是一种罕见且进展迅速的疾病，与显著的发病率和死亡率相关。虽然患者更常表现为急性心力衰竭，但由于临床表现的异质性，诊断较为困难。
本病例报告介绍了一名此前健康的59岁越南女性，她最初因晕厥和机动车事故就诊，随后左心室功能迅速下降。她最初的超声心动图提示为浸润性心肌病。活检确诊为巨细胞性心肌炎，她接受了联合免疫抑制治疗。在首次入院27天后，她未能从严重的多器官功能障碍中恢复，患者接受了姑息治疗并去世。
本病例突出了巨细胞性心肌炎可能呈现的多种方式。即使在就诊时没有心源性休克，在评估病因不明的新型心肌病时也应考虑巨细胞性心肌炎。这种疾病的诊断对治疗和预后具有明确的临床意义。
