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July 22, 1961

Granulomatous (Fiedler's) Myocarditis with Extracardiac InvolvementA Case Report with Sudden Death

JAMA. 1961;177(3):184-186. doi:10.1001/jama.1961.03040290012003

Isolated myocarditis is a rare condition, described by Fiedler in 1900, which commonly ends in sudden death. By definition, demonstrable lesions are limited to the heart, but cases of extracardiac involvement are known. One more case of granulomatous myocarditis is reported here. The patient was a 54-year-old housewife who had a series of fainting spells associated with various mental disturbances and one episode of incontinence. Death came suddenly, less than three weeks after the first attack. Postmortem exmination revealed granulomatous lesions in the heart and also in the lungs. Certain resemblances between granulomatous myocarditis and sarcoidosis as to symptoms and microscopic changes suggest a relation between the two conditions, but this remains unsettled.