Giant cell myocarditis is a rare form of autoimmune myocarditis with high morbidity and mortality that affects mainly middle-aged adults. We report a case study of a 70-year-old man on chronic immunosuppression who presented with sustained ventricular tachycardia and symptoms of acute systolic heart failure, both with poor response to standard measures. A decision to pursue endomyocardial biopsy established the diagnosis of GCM and lead to initiation of immunosuppressive therapy and a favourable outcome. Our case illustrates that a low threshold for endomyocardial biopsy in new onset heart failure can lead to actionable information even in patients of advanced age.

2nd Department of Medicine Department of Cardiovascular Medicine 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

Division of Cardiovascular Medicine University of Utah Health Salt Lake City Utah USA

Institute of Pathology of the 1st Faculty of Medicine and General University Hospital Prague Czech Republic

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