Do you sometimes feel like your heart is pounding, pounding, or there's something strange in your chest? These are things we sometimes don't pay much attention to, but they can be symptoms of some rare heart conditions. Today we're going to talk about one such rare, but potentially serious heart condition. Its name is Giant Cell Myocarditis, or in English `(Giant Cell Myocarditis)`.
What is Giant Cell Myocarditis? Let's understand it simply.
Simply put, Giant Cell Myocarditis is a very rare type of heart muscle inflammation . Inflammation is a type of swelling. What happens in this disease is that some of our body's 'inflammatory cells' get together and form a type of large cell called 'Giant Cells'. These giant cells, like enemies, attack your heart muscle and cause scarring.
Think about it, our heart is like a water pump. It's what pumps blood throughout the body. So, when these giant cells damage the heart muscle, the heart can't work properly. That means:
- It's getting harder to pump blood .
- When the heart beats, not all parts of it contract at the same time .
- The electrical signals that control the heartbeat are disrupted , and those signals do not travel through the heart properly.
Because this condition can become severe very quickly, people with this disease often have to undergo a heart transplant .
What is the difference between Myocarditis and Giant Cell Myocarditis?
Myocarditis is also an inflammation of the heart muscle. However, giant cell myocarditis is a very rare and specific type of myocarditis. Like other types of myocarditis, it can also cause heart rhythm abnormalities, or arrhythmias.
Viral infection is usually the main cause of myocarditis. However, researchers are still trying to figure out why this giant cell myocarditis (GCM) occurs.
Who is most affected by this condition? How common is it?
Giant cell myocarditis (GCM) most often occurs in healthy young and middle-aged people . However, it can occur in people of any age, regardless of gender.
As far as how common this is, it's very, very rare. Doctors diagnose this disease in less than one in 100,000 people per year. That means it's reported in about 0.13 per 100,000 people .
What are the symptoms? How do we recognize them?
Early symptoms of giant cell myocarditis (GCM) may include:
- Heart palpitations (feeling like your heart is beating fast or your chest is pounding)
- Chest pain
- Difficulty breathing or shortness of breath (Shortness of breath)
- Swollen ankles
- Extreme tiredness
Often these symptoms start very quickly . Later, heart rhythm abnormalities may develop. More than half of people with this disease develop dangerous heart rhythm irregularities (`Ventricular arrhythmias`), which start in the chambers of the heart . These can cause the heart to stop suddenly.
Also, the heart rate can be very fast or very slow. You may feel dizzy or faint . Some people may even develop a serious condition called ``cardiogenic shock,'' where the heart cannot pump blood properly.
Why does this happen? What are the reasons?
Researchers still don't know exactly what causes giant cell myocarditis (GCM). They are looking into a variety of things. For example, they are looking into whether certain infections, abnormalities in your immune system, or something in your genes may make you more likely to develop the disease.
Another thing is that about 20% of people who develop this disease have been found to have autoimmune disorders . Autoimmune diseases are when our body's defense system, that is, the immune system, attacks our own body's cells. So, these types of diseases can also be a cause or risk factor for developing GCM.
How do you accurately diagnose this disease?
To confirm the diagnosis of giant cell myocarditis (GCM), your doctor will need to take a small sample of your heart muscle . This is called a heart biopsy. The sample is sent to a laboratory and examined by a cardiac pathologist.
It is important to have the sample examined by a specialist like this because the results of a biopsy of giant cell myocarditis can be similar to those of other diseases that cause inflammation of the heart muscle, such as cardiac sarcoidosis. Therefore, an accurate diagnosis is essential for a treatment plan.
This `(Biopsy)` test is a risky one, but it is the only way to know for sure if you have this disease. Some of the complications that can occur with a heart muscle `(Biopsy)` are:
- Pericardial effusion (fluid accumulation in the membrane around the heart)
- Cardiac tamponade
- Perforation of the wall of a chamber of the heart (ventricular wall)
When taking this sample, the doctor inserts a very thin tube, called a catheter, into your heart through a large blood vessel in your neck or groin. This catheter is guided into the heart using a special device (`Imaging`). Then, a special tool inside the catheter takes a small piece of heart muscle.
Sometimes more than one `(Biopsy)` may be needed. This is because `(GCM)` may not affect all parts of the heart in the same way. Doing something like an `(MRI)` scan of the heart will help the doctor decide exactly where to take the `(Biopsy)`.
What other tests do you do?
To make sure you don't have another heart condition, your doctor may order other tests. Some of these include:
- Electrocardiogram (EKG)
- Echocardiogram
- Cardiac catheterization
What are the treatments?
Your doctor may prescribe various medications to treat this condition. These medications include:
- Can reduce inflammation .
- It helps prevent the occurrence of abnormal heart rhythms or heart failure.
- You may be given more time until you need a heart transplant.
- Helps extend life .
Other treatments for giant cell myocarditis (GCM) help control heart failure and abnormal heart rhythms. These treatments may include:
- Medicines
- Catheter ablation
- A pacemaker
- An implantable cardioverter defibrillator (ICD) is a device that is implanted in the body to regulate and shock the heart rate.
- A heart transplant
While waiting for a heart transplant, you may need a left ventricular assist device (LVAD). If you need a heart transplant, you will need to have the tests and treatment at a hospital that has the facilities for that.
What kind of medications are used?
Treatment for giant cell myocarditis (GCM) includes medications that control your immune system (immunosuppressants). That is, medications that reduce immunity. Some of these include:
- Cyclosporine (e.g. Gengraf®, Neoral®)
- Corticosteroids like prednisone (e.g. Sterapred®, Rayos®)
- Azathioprine (e.g. Imuran®, Azasan®)
It is very important to start these medications as soon as possible. Without these medications, a heart transplant can be required within three months of the onset of symptoms, or the condition can be fatal. However, people taking medications that control the immune system usually live for about 12 months.
Are there any side effects of the treatment?
Side effects can vary depending on the type of medication you take. Some of the most common side effects include:
- Muscle pain or weakness
- Headache
- High blood sugar
- Diarrhea
- Insomnia
If you feel anything like this, don't forget to tell your doctor.
What will life be like with this disease?
If you have giant cell myocarditis (GCM), it can lead to heart failure or heart block . When these conditions become severe (usually within about five months), you may need a heart transplant, if you qualify. Many people become symptom-free after receiving a new heart, but they will need to take many new medications to support the new heart.
Can giant cell myocarditis be prevented?
Although people can live longer with giant cell myocarditis (GCM) than they used to, it is still a fatal disease without a heart transplant . For much of the 1900s, people with GCM lived for less than three months. But today, if the disease is diagnosed early and treated with drugs that control the immune system, 90% of people with GCM live for at least a year. These drugs can buy you months or years until you need a heart transplant.
What is the prognosis of the disease?
After a heart transplant, about 71% of people with giant cell myocarditis (GCM) survive for five years (82% in another study) . Ten years after a heart transplant, the survival rate is about 68%.
However, giant cells can reappear in between 10% and 50% of people who receive a new heart. This can happen anywhere from a few weeks to nine years after the transplant. If this happens, you will need to take steroids for several months.
How do I take care of myself?
If you have giant cell myocarditis (GCM), you should avoid competitive sports for at least three to six months . Once your GCM is stable, ask your doctor if it's safe to gradually return to exercise.
When do you need to see a doctor?
If you experience severe side effects from your medication, or if your symptoms seem to be getting worse, see your doctor immediately . It is also important to see your doctor on a regular basis to monitor your condition.
When do you need to go to the Emergency Treatment Unit (ETU) ?
If you experience severe chest pain or difficulty breathing, call 911 or go to an emergency room immediately. This is very important, as these can be signs of a serious condition.
What questions should I ask the doctor?
Don't forget to ask these questions when you see your doctor:
- How often do I need to come for follow-up appointments?
- Is there a support group that people with this disease can join?
- Do you think I will need a heart transplant?
Finally, the most important thing to remember
So, now you probably understand that Giant Cell Myocarditis is a very rare, but very serious heart disease. The most important thing is to recognize the symptoms early, seek medical advice, and start proper treatment. Don't worry, because there are treatments for this disease now, and life expectancy can be extended. Therefore, if you feel something unusual about your heart, don't ignore it and see a doctor. Take care of your heart!
` Giant Cell Myocarditis, Giant Cell Myocarditis, Heart Disease, Heart Transplant, Giant Cells, Heart Rhythm Disorders, Immune System, Heart Attack, Heart Disease
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