From a case report and review:
Idiopathic GCM is a rare and often fatal disease . Initial presentation can be one of rapidly progressive HF, ventricular arrhythmia, heart block, and/or symptoms mimicking acute coronary syndrome as seen in this case presentation [1, 2]. GCM is characterized histopathologically as a diffuse or multifocal inflammatory infiltrate with multinucleated giant cells associated with myocardial necrosis and an absence of sarcoid-like granulomas [1, 3]. Pathology remains the cornerstone of diagnosis . Once the diagnosis is confirmed, there is considerable evidence to support the use of combined immunosuppression with calcineurin inhibition and corticosteroid therapy, as opposed to corticosteroids alone, in order to prolong transplant-free survival [1–4].