Idiopathic Giant Cell Myocarditis Diagnosed in the Native Explanted Heart.

We report the case of a 35-year-old woman suffering a rapidly progressive congestive heart failure. Echocardiogram and cardiac catheterization study showed a restrictive pattern with a ventricular ejection of 45%. Her clinical condition was dramatically deteriorated, and an urgent orthotopic cardiac transplantation was performed. Histological examination of the native explanted heart revealed an idiopathic giant-cell myocarditis. Posttransplant routine endomyocardial biopsies showed acute rejection but no evidence of recurrence. The patient's physical condition is good more than 14 months after transplantation. The outcome of the 11 cases of giant-cell myocarditis treated by heart transplantation, including the present, are reviewed. Heart transplantation is an excellent option for giant-cell myocarditis treatment since it improves survival. Recurrence rate is less than 50% and, when present, is usually responsive to intensive immunosuppression. Pretransplant endomyocardial biopsies are not always diagnostic of giant-cell myocarditis. [ABSTRACT FROM AUTHOR]