Cause of sudden death: giant cell myocarditis

Sudden cardiac deaths due to giant cell myocarditis (GCM) are uncommon. Giant cell myocarditis is an inflammatory myocardial disease. 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 cardiac muscles 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. It mostly occurs in young adults [1]. It is characterized by resistant sudden arrhythmias and left ventricular failure. Its etiology is still unknown and fatal. GCM rapidly proceeds and clinical view develops very fast in comparison to non-specific lymphocytic myocarditis that usually leads to sudden deaths before any diagnosis [2,3]. Giant cell myocarditis may cause serious heart failure, complete heart block, malignant ventricular arrhythmias. It usually starts with sudden and severe breathing problem, chest pain, hypotension and orthopnea. Medical treatment is usually unsuccessful [4]. GCM cases are very rare and a sometimes create serious diagnostic problems of the sudden cardiac deaths if not properly investigated and evaluated.