A case report of giant cell myocarditis after a syncope-related motor vehicle accident: An atypical presentation for a life-threatening condition

Abstract

Background: Giant cell myocarditis (GCM) is a rare and rapidly progressive disease associated with significant morbidity and mortality. Whilst patients more frequently present with acute heart failure, diagnosis is difficult due to heterogeneity in clinical presentations. Case summary: This case report presents a previously healthy 59-year-old Vietnamese woman who initially presented with syncope and a motor vehicle accident who developed rapid decline in left ventricular function. Her initial echocardiogram was suggestive of an infiltrative cardiomyopathy. GCM was confirmed on biopsy, and she received combined immunosuppression. Twenty-seven days following her initial presentation to hospital, she was unable to recover from severe multi-organ dysfunction, and the patient was palliated and passed away. Discussion: This case highlights the varied manner in which GCM may present. Even in the absence of cardiogenic shock at presentation, giant cell myocarditis should be considered in the evaluation of new cardiomyopathy of uncertainty aetiology. Diagnosis of this condition has distinct clinical implications on management and prognosis.