A case of giant cell myocarditis with atrioventricular blockade and progressive cardiac insufficiency is reported that required implantation of an artificial pacemaker and ended in the death of the patient. The diagnosis was confirmed by a histological study following autopsy. The difficulty of diagnosis of this rare form of myocarditis with an aggressive clinical course is emphasized. It is concluded that life-time endomyocardial biopsy, combined immunosuppressive therapy, and frequently heart transplantation taken together may prolong life expectancy in such patients.

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