Giant cell myocarditis is a rare and fatal disease which may result in heart failure, complete heart block, or ventricular arrhythmias. We describe a patient who previously had been discharged from our institution with a left ventricular assist device and immunosuppressive therapy for management of his giant cell myocarditis. His subsequent course was complicated by further deterioration of heart function which required multiple mechanical circulatory support devices. He successfully received a heart transplant which later had recurrence of giant cell myocarditis. This case highlights the challenges of left and right sided mechanical assist devices in managing giant cell myocarditis.

AG is a 33-year-old Hispanic man with a history of heart failure with reduced ejection fraction secondary to giant cell myocarditis implanted with a HeartMate3 left ventricular assist device (LVAD) who presented after experiencing low flow alarms.