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Giant cell myocarditis: a life-threatening disorder heralded by orbital myositis

Muhammad Sajawal Ali1, Benjamin I Mba1, Aliya Noor Husain2

  • 1Department of Medicine, John H Stroger, Jr, Hospital of Cook County, Chicago, Illinois, USA.

BMJ Case Reports
|March 25, 2016
PubMed

Insights

Orbital myositis (OM) can present with cardiac issues. Giant cell myocarditis (GCM) should be suspected in OM patients with ventricular tachycardia and heart failure.

Area of Science:

  • Cardiology
  • Immunology

Background:

  • Orbital myositis (OM) is an inflammatory condition affecting eye muscles.
  • Cardiac involvement in OM is rare but can be severe.

Observation:

  • A 40-year-old male with OM presented with ventricular tachycardia and cardiogenic shock.
  • Initial diagnosis considered arrhythmogenic right ventricular cardiomyopathy due to right ventricular dilation.
  • Cardiac MRI was limited by arrhythmias.

Findings:

  • Endomyocardial biopsy confirmed giant cell myocarditis (GCM).
  • This is the seventh reported case of GCM associated with OM.
  • The patient required an implantable cardioverter-defibrillator.

Implications:

  • Clinicians should consider GCM in OM patients with cardiac symptoms.
  • Early diagnosis and treatment of GCM in OM patients may improve outcomes.
  • Further research is needed to understand the link between OM and GCM.

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