Work

Recurrent Heart Failure From Fulminant Giant Cell Myocarditis Following COVID-19 Infection Requiring Heart Transplantation

Year: 2025

Type: article

Abstract: BACKGROUND: Giant cell myocarditis (GCM) is a rare, rapidly progressive inflammatory cardiomyopathy marked by T cell-mediated myocardial destruction. Early diagnosis is difficult, and outcomes are poor without aggressive treatment. CASE SUMMARY: A 46-year-old woman with recent COVID-19 presented with flulike symptoms and dyspnea. She rapidly decompensated into cardiogenic shock, requiring venoarterial extracorporeal membrane oxygenation. Endomyocardial biopsy revealed fulminant necrotizing myocarditis, prompting treatment with immunosuppressants. She was decannulated and discharged but returned 2 weeks later in shock, again requiring venoarterial extracorporeal membrane oxygenation. She ultimately underwent orthotopic heart transplantation. Explanted pathology confirmed GCM. DISCUSSION: GCM can mimic other forms of myocarditis but requires biopsy for diagnosis. This case underscores the fulminant course of GCM, the utility of early mechanical support, and the importance of prompt recognition.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104173

Authors: Alan Amedi, Jay N. Patel, Zachary Brennan, Laura Dichiacchio, Michael Bowdish, Tyler Gunn

Institutions: Cedars-Sinai Medical Center, Cedars-Sinai Smidt Heart Institute, California University of Science and Medicine

Language: English

Topic: Viral Infections and Immunology Research

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850