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Updated: Aug 21, 2026

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
08:56

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

Echocardiographic features of atrial myocarditis with giant cells: a case report

Kwan-K Law1, Josepha Binder, Leslie T Cooper

  • 1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|September 29, 2004
PubMed

Insights

Wegener's granulomatosis can cause distinct endothelial thickening in the heart. While immunosuppressive therapy resolved this thickening, it did not reverse the associated restrictive cardiomyopathy.

Area of Science:

  • Cardiology
  • Immunology
  • Pathology

Background:

  • Restrictive cardiomyopathy presents a diagnostic challenge, often with unclear etiologies.
  • Endothelial dysfunction can contribute to cardiac pathology.

Observation:

  • Transesophageal echocardiography revealed distinct endothelial thickening of the atrial wall and pulmonary vein orifices in a patient with restrictive cardiomyopathy.
  • Echocardiographically guided endomyocardial biopsy showed an inflammatory infiltrate rich in giant cells within the thickened endocardium.

Findings:

  • The findings suggested an immune-mediated mechanism for the endocardial thickening.
  • Antineutrophil cytoplasmic autoantibody assay was positive, supporting a diagnosis of Wegener's granulomatosis.
  • Immunosuppressive therapy led to complete resolution of the endocardial thickening.

Implications:

  • Wegener's granulomatosis should be considered in cases of unexplained restrictive cardiomyopathy with specific echocardiographic findings.
  • While immunosuppression can resolve inflammatory cardiac manifestations, it may not reverse established myocardial damage.
  • This case highlights the importance of integrating echocardiography, biopsy, and serological testing for diagnosing rare cardiac involvements in systemic vasculitis.

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