Management of Patients With Giant Cell Myocarditis: JACC Review Topic of the Week.
Algorithms
Biomarkers
/ blood
Biopsy
Cardiovascular Agents
/ therapeutic use
Defibrillators, Implantable
Electrocardiography
Endocardium
/ pathology
Giant Cells
/ pathology
Heart
/ diagnostic imaging
Heart Transplantation
Heart-Assist Devices
Humans
Immunosuppressive Agents
/ therapeutic use
Myocarditis
/ diagnosis
Natriuretic Peptide, Brain
/ blood
Troponin I
/ blood
cardiogenic shock
endomyocardial biopsy
giant cell myocarditis
heart block
heart failure
heart transplant
immunosuppression
left ventricular assist device
ventricular arrhythmia
Journal
Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365
Informations de publication
Date de publication:
02 03 2021
02 03 2021
Historique:
received:
02
09
2020
revised:
20
11
2020
accepted:
24
11
2020
entrez:
26
2
2021
pubmed:
27
2
2021
medline:
29
9
2021
Statut:
ppublish
Résumé
Giant cell myocarditis is a rare, often rapidly progressive and potentially fatal, disease due to T-cell lymphocyte-mediated inflammation of the myocardium that typically affects young and middle-aged adults. Frequently, the disease course is marked by acute heart failure, cardiogenic shock, intractable ventricular arrhythmias, and/or heart block. Diagnosis is often difficult due to its varied clinical presentation and overlap with other cardiovascular conditions. Although cardiac biomarkers and multimodality imaging are often used as initial diagnostic tests, endomyocardial biopsy is required for definitive diagnosis. Combination immunosuppressive therapy, along with guideline-directed medical therapy, has led to a paradigm shift in the management of giant cell myocarditis resulting in an improvement in overall and transplant-free survival. Early diagnosis and prompt management can decrease the risk of transplantation or death, which remain common in patients who present with cardiogenic shock.
Identifiants
pubmed: 33632487
pii: S0735-1097(20)38134-1
doi: 10.1016/j.jacc.2020.11.074
pii:
doi:
Substances chimiques
Biomarkers
0
Cardiovascular Agents
0
Immunosuppressive Agents
0
Troponin I
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1122-1134Informations de copyright
Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Funding Support and Author Disclosures All authors have reported that they have no relationships relevant to the contents of this paper to disclose.