Giant cell myocarditis and cardiac sarcoidosis – update 2015

Czech version

Authors: M. Kubánek ¹; L. Voska ²
Authors‘ workplace: Klinika kardiologie, Kardiocentrum, IKEM, Praha ¹; Pracoviště klinické a transplantační patologie, Transplantcentrum, IKEM, Praha ²
Published in: Kardiol Rev Int Med 2015, 17(4): 295-299
Category: Cardiology Review

Overview

Giant cell myocarditis (GCM) and cardiac sarcoidosis are rare forms of myocarditis resistant to conventional management of heart failure and arrhythmias. GCM usually presents as fulminant myocarditis or subacute progressive non-ischemic heart failure. Advanced atrioventricular blockade and/ or ventricular tachycardias either accompany the aforementioned heart failure syndromes or represent predominant clinical manifestations of GCM. Except for the fulminant clinical course, cardiac sarcoidosis has a clinical presentation similar to GCM. However, its progression is slower, usually across a time interval of several months. The diagnosis of GCM is based mainly on endomyocardial biopsy. In contrast, endomycardial biopsy has a low sensitivity for the diagnosis of cardiac sarcoidosis. In the case of non-diagnostic endomyocardial biopsy, we need histological detection of extracardiac sarcoidosis and signs of cardiac involvement revealed by magnetic resonance imaging or positron emission tomography to diagnose cardiac sarcoidosis. Immunosuppressive treatment is a key component of the management of both diseases. Non-pharmacologic methods of heart failure and arrhythmia management are often necessary.

Keywords:
giant cell myocarditis – cardiac sarcoidosis

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