Giant cell myocarditis is an inflammatory disease of the heart muscle (myocardium). In this rare and serious disease, large inflammatory cells called giant cells are found in the heart muscle. These giant cells cause widespread inflammation and necrosis (tissue death) in the heart muscle. Giant cell myocarditis progresses rapidly and usually affects young and middle-aged adults. This disease can lead to serious complications such as heart failure, arrhythmias (irregular heart rhythms), and sudden cardiac death.
What Causes Giant Cell Myocarditis?
The exact causes of giant cell myocarditis are not fully known. It is thought to develop idiopathically (for unknown reasons). However, some research suggests that autoimmune mechanisms and genetic predispositions may play a role in the development of the disease. Autoimmune mechanisms cause the immune system to mistakenly attack the heart muscle, leading to inflammation and tissue damage.
Additionally, giant cell myocarditis can sometimes be associated with other diseases. For example, some viral infections, systemic inflammatory diseases, and hypersensitivity reactions to certain drugs can contribute to the development of this disease. However, these connections are not always clear, and the underlying mechanisms of the disease are not fully understood.
What Are the Symptoms of Giant Cell Myocarditis?
The symptoms of giant cell myocarditis include:
- chest pain
- palpitations
- shortness of breath
- fatigue
- fainting
- symptoms of heart failure
- irregular heart rhythm
How Is Giant Cell Myocarditis Diagnosed?
Diagnosing giant cell myocarditis requires the evaluation of symptoms, a physical examination, and a combination of diagnostic tests. The diagnostic process generally includes the following steps:
Medical History and Physical Examination: The doctor evaluates the patient’s symptoms and medical history. During the physical examination, the heart’s sound and rhythm are listened to.
Electrocardiogram (ECG): This test, which measures the electrical activity of the heart, can detect arrhythmias and abnormalities in the heart muscle.
Echocardiography: This imaging method evaluates the structure and function of the heart muscle. Thickening of the heart muscle, loss of function, and other abnormalities can be observed.
Heart Biopsy: The most important test for a definitive diagnosis is the examination of a tissue sample taken from the heart muscle under a microscope. The presence of giant cells and inflammation is confirmed by biopsy.
Blood Tests: Inflammation markers and other biochemical parameters are evaluated. Specific antibody tests may also be conducted to investigate the presence of autoimmune diseases.
Magnetic Resonance Imaging (MRI): It shows inflammation and structural changes in the heart muscle in detail.
How Is Giant Cell Myocarditis Treated?
The treatment of giant cell myocarditis aims to halt the progression of the disease, alleviate symptoms, and prevent complications. Treatment options include:
Immunosuppressive Therapy: Corticosteroids (e.g., prednisone) and other immunosuppressive drugs (e.g., azathioprine, cyclosporine) are used to suppress the autoimmune response. These drugs help prevent the immune system from attacking the heart muscle.
Heart Failure Treatment: Medications such as diuretics, ACE inhibitors, and beta-blockers are used to manage symptoms of heart failure.
Anti-arrhythmic Drugs: Anti-arrhythmic drugs may be prescribed to control irregular heart rhythms.
Supportive Therapy: Lifestyle changes and dietary recommendations may be made to support the general health of patients.
Heart Transplant: In severe cases, when heart failure progresses and other treatments are insufficient, a heart transplant may be necessary.
How Should Giant Cell Myocarditis Be Managed?
Managing giant cell myocarditis requires a multidisciplinary approach to control the disease and improve patients’ quality of life. Management strategies include:
Regular Medical Follow-up: Patients need regular follow-up by specialist doctors such as cardiologists and immunologists. Periodic evaluations should be conducted to monitor the response to treatment and manage possible side effects.
Medication Management: Proper and regular use of immunosuppressive therapy and other medications is important. Patients should be informed about the dosage and usage of their medications.
Lifestyle Changes: Patients should adopt a healthy lifestyle to protect heart health. This includes balanced nutrition, regular exercise, and avoiding stress.
Psychological Support: Living with a chronic and serious illness can lead to psychological stress and anxiety. Psychological support and counseling services can help patients maintain their emotional well-being.
Emergency Plan: Patients and their families should have a plan for possible emergencies. Immediate intervention is necessary for situations like sudden cardiac arrest or severe arrhythmias.
