The Changing Role for Endomyocardial Biopsy in the Diagnosis of Giant-Cell Myocarditis

Abstract

Endomyocardial biopsy (EMB) is central to the diagnosis of giant-cell myocarditis (GCM) and planning further management. There is, however, no guideline-directed recommendation on re-biopsy or left ventricular EMB in a suspected case of acute, fulminant myocarditis following an indeterminate first biopsy. This manuscript illustrates, with a case, the changing role for EMB in the current era in the diagnosis of GCM.Electronic supplementary materialThe online version of this article (doi:10.1007/s40119-014-0028-5) contains supplementary material, which is available to authorized users.

Fulminant giant-cell myocarditis on mechanical circulatory support: Management and outcomes of a French multicentre cohort

“…Moreover, magnetic resonance imaging-guided [33] or systematic left ventricular biopsies [34][35][36] could further enhance EMB sensitivity.…”

Fulminant Myocarditis: A Review of the Current Literature

“…ECG showed a recommended if there is clinical suspicion for giant cell myocarditis. 12,13 The characteristic histopathology reveals a mixed inflammatory infiltrate containing lymphocytes, plasma cells, macrophages, and eosinophils, along with numerous multinucleated giant cells without granulomas. This is typically associated with widespread myocyte necrosis, often of the coagulative type ( Figure 2).…”

“…This is typically associated with widespread myocyte necrosis, often of the coagulative type ( Figure 2). 1,13 Treatment of giant cell myocarditis is aimed at attenuating T-cell function.…”

Giant Cell Myocarditis: Case Review

“…The basis of its diagnosis is endomyocardial biopsy (EMB) (2). Even with optimal medical care, GCM typically has a bad prognosis (3).…”