Granulomatous (Fiedler's) Myocarditis with Extracardiac Involvement

Sarcoidosis

“…In some of these, not only has the distribution of the granulomatous inflammation in the heart been similar to that observed in undoubted cases of sarcoidosis with cardiac involvement, but granulomas have been found in one or more other sites (Gent zen, 1937;Hirayama, 1939 ;Didion, 1943); Long, 1961; one of 11 cases reported by in such cases, there is little reason to question correctness of categorization as sarcoidosis.…”

Fiedler's Myocarditis

“…Although the origin of the giant cells has given rise to conjecture (Saphir, 1941(Saphir, , 1942Tesluk, 1956;Collyns, 1959;Long, 1961), it seems clear that in this case the giant cells were from degenerating muscle. Where the heart muscle fibres were cut transversely, tangentially, or longitudinally so the giant cells were cut in the same fashion.…”

“…In 1956 Dilling could find 13 previously reported examples of myocarditis with giant cells and since then at least 6 others have been described, 3 in men (Tesluk, 1956;Collyns, 1959;Rab, Choudhury, and Choudhury, 1963), and 3 in women (Naddachina, 1961;Long, 1961;D'Agostino, Avella, and Maddaluno, 1962) ranging from 19 to 54 years in age. This patient's clinical picture together with the serum enzymes and electrocardiogram suggested a diagnosis of myocarditis and in the total absence of any obvious etiological agency or cardiac enlargement, a presumptive diagnosis of Fiedler's myocarditis was made.…”

Sudden Cardiac Death due to Giant Cell Inflammatory Processes*

“…In contrast, Rashid and Williams (33) reported that the diagnosis of giant cell myocarditis cannot be made on examination, but necessitates a thorough exclusion of involvement of other organs or lymph nodes. Long (48) has postulated that giant cell myocarditis may be a rare form of sarcoidosis.…”