About giant cell myocarditis

What is giant cell myocarditis?

Giant cell myocarditis is a rare cardiovascular disorder that occurs for unknown reasons (idiopathic). It is characterized by inflammation of the heart muscle (myocardium), a condition referred to as myocarditis. Inflammation is caused by widespread infiltration of giant cells associated with other inflammatory cells and heart muscle cell destruction. Giant cells are abnormal masses produced by the fusion of inflammatory cells called macrophages. Individuals with giant cell myocarditis may develop abnormal heartbeats, chest pain and, eventually, heart failure. Many individuals eventually require a heart transplant. The disorder most often occurs in young adults.

What are the symptoms for giant cell myocarditis?

The onset of symptoms of giant cell myocarditis is often rapid. Initial symptoms may include Swelling of the ankles, Chest pain, heart Palpitations, Fatigue, and Shortness of breath (dyspnea) especially upon exertion or lying flat. Affected individuals eventually develop Irregular heartbeats (arrhythmias) such as abnormally fast (tachycardia) or slow (brachycardia) heartbeats. Arrhythmias may cause sudden episodes of Lightheadedness or loss of consciousness.

The above mentioned symptoms of giant cell myocarditis occur due to congestive heart failure or heart block. These two heart abnormalities are progressive and eventually result in life-threatening complications. In individuals with giant cell myocarditis, the average time from symptom onset to life-threatening complications or heart transplant is five and a half months.

The normal heart has four chambers. The two upper chambers, known as atria, are separated from each other by a fibrous partition known as the atrial septum. The two lower chambers are known as ventricles and are separated from each other by the ventricular septum. Valves connect the atria (left and right) to their respective ventricles. The valves allow for blood to be pumped through the chambers. Blood travels from the right ventricle through the pulmonary artery to the lungs where it receives oxygen. The blood returns to the heart through pulmonary veins and enters the left ventricle. The left ventricle sends the now oxygen-filled blood into the main artery of the body (aorta). The aorta sends the blood throughout the body.

Congestive heart failure is a condition in which abnormal enlargement or widening (dilatation) of one or more of the chambers of the heart results in weakening of the heart’s pumping action, causing a limited ability to circulate blood to the lungs and the rest of the body. This leads to fluid buildup in the heart, lungs and various body tissues. In some cases, all four chambers of the heart may be affected. Symptoms may include Fatigue, Shortness of breath (dyspnea) upon exertion, Swelling of the legs and feet, and Chest pain.

Heart block may be partial or complete. In the mild form of heart block (first degree), the two upper chambers of the heart (atria) beat normally, but the contractions of the two lower chambers (ventricles) slightly lag behind. In the more severe forms (second degree), not all of the atrial beats are conducted to the ventricles. In complete heart block (third degree), the atria and ventricles beat independently. Individuals with first or second degree heart block may not experience symptoms (asymptomatic). However, individuals with complete heart block may experience episodes of unconsciousness (syncope), breathlessness, and/or Fatigue.

What are the causes for giant cell myocarditis?

The exact cause of giant cell myocarditis is unknown. Approximately 20 percent of cases occur in individuals with autoimmune disorders suggesting that autoimmunity may play a role in the development of giant cell myocarditis. Autoimmune disorders are caused when the body’s natural defenses against “foreign” or invading organisms begin to attack healthy tissue for unknown reasons.

Autoimmune disorders associated with giant cell myocarditis include inflammatory bowel disease such as Crohn’s disease. Some cases of giant cell myocarditis have been associated with a tumor of the thymus (thymoma). The thymus is a relatively small organ behind the breastbone that is thought to play an important role in the immune system until puberty.

What are the treatments for giant cell myocarditis?

Treatment Standard and supportive treatment options for cardiac failure and arrhythmias are recommended. These treatment options may include the insertion of a pacemaker or implantable heart defibrillator.

Affected individuals may require a heart transplant. Affected individuals are often evaluated for heart transplantation shortly after diagnosis. In 20-25% of cases, infiltration of giant cells has recurred after heart transplantation. Immunosuppresssion with drugs that include cyclosporine prolong survival free of transplantation. GCM can recur after therapy in both the native and allografted heart.

What are the risk factors for giant cell myocarditis?

Though research has been going on for years, the actual cause of giant cell myocarditis is still not clear.

The risk factors for giant cell myocarditis are-

  • People with autoimmune disorders are prone to this disease; however, people of any age, gender, lifestyle, or food habit can be a sufferer of this disease.
  • Patients with autoimmune diseases like type 1 diabetes, Rheumatoid arthritis, psoriatic arthritis, multiple sclerosis, inflammatory bowel disease, etc., are likely to have giant cell myocarditis.
  • If someone has undergone major skin injuries or infection, they have the risk of having this disease.
  • If someone has undergone major chest injuries, they also have the risk of having this disease.
  • Cancer patient who has undergone dialysis, radiation treatment, and certain heavy medications can have this disease.
  • Eating disorders also sometimes can lead to giant cell myocarditis.
  • In children, myocarditis can even take place due to common cold, hepatitis B and C, covid-9, etc.
Though giant cell myocarditis is a fatal disease that weakens your heart muscle, some cases show patients with this disease live a long life after treatment. To avoid such deadly diseases, we can take care of our heart health properly and make regular body checkups.

Symtpoms
Angina (chest pain),Fatigue,Lightheadedness or dizziness with exercise,Shortness of breath when exercising
Conditions High blood cholesterol,Diabetes,Obesity and overweight,Smoking,Physical inactivity,High blood pressure (hypertension)
Drugs Anticoagulants,Antiplatelet Agents and Dual Antiplatelet Therapy,ACE Inhibitors,Angiotensin II Receptor Blockers,Angiotensin Receptor-Neprilysin Inhibitors,Beta Blockers,Calcium Channel Blockers,Cholesterol-lowering medications,Digitalis Preparations,Diuretics,Vasodilators

Is there a cure/medications for giant cell myocarditis?

Giant cell myocarditis is a very rare cardiovascular disorder that occurs due to progressive inflammation in the heart muscle.

Even after years-long research, the actual cause and proper treatment or medications for this disease have not been found yet.

Here are some highlights of the giant cell myocarditis treatment-

  • If other treatments remain ineffective, a heart transplant can be a solution to giant cell myocarditis, at least to add a few more years to the patient’s life. But there are chances it will develop in the new heart too.
  • A pacemaker or defibrillator may help the patient to keep a normal heartbeat.
  • Immunosuppressive treatments may prevent the heart from the attack by the giant cells, allowing a person to survive at least 1 year on average after the symptoms have been started.
  • Oxygen therapy can also heal the patient to some extent.
  • Pain relief medications are also sometimes prescribed. This might not be a treatment to cure the disease but can at least relieve the pain to some extent.
Giant cell myocarditis is a serious disease, a rare one even to identify quickly. Therefore it is very important to contact a doctor as soon as possible once the symptoms are experienced.

Symtpoms
Angina (chest pain),Fatigue,Lightheadedness or dizziness with exercise,Shortness of breath when exercising
Conditions High blood cholesterol,Diabetes,Obesity and overweight,Smoking,Physical inactivity,High blood pressure (hypertension)
Drugs Anticoagulants,Antiplatelet Agents and Dual Antiplatelet Therapy,ACE Inhibitors,Angiotensin II Receptor Blockers,Angiotensin Receptor-Neprilysin Inhibitors,Beta Blockers,Calcium Channel Blockers,Cholesterol-lowering medications,Digitalis Preparations,Diuretics,Vasodilators

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