Giant-cell myocarditis (GCM) is known as a rare, rapidly progressive, and frequently fatal myocardial disease in young and middle-aged adults. However, few cases have been reported on GCM in older patients. The paucity of reported cases on the elderly may reflect less frequent diagnosis or more or less fulminant course of disease in this population. Infection, autoimmune processes, and genetics have all been implicated in the pathogenesis of this disease, but the etiology is likely to be a complex multifactorial process. It is attributed to a T lymphocyte-mediated inflammation of the heart muscle and associates with systemic autoimmune diseases in 20% of cases [1,2]. The most common early manifestations are heart failure, ventricular arrhythmias, and atrioventricular block, but GCM may also appear as an acute myocardial infarction and rarely presents as an unexpected sudden cardiac death. Due to this unspecific clinical presentation of the patients, which may also be caused by other heart disease, the diagnosis of GCM fully depends on microscopy of the heart muscle with a sensitivity of 80% to 85% [1,2]. The histological hallmark of GCM is a multifocal inflammatory infiltrate manifested by many multinucleated giant cells and by extensive myocardial cell necrosis in the absence of granuloma formation [3]. Because of possible life threatening complications associated with GCM and the potential for benefit from treatment, early biopsy is recommended. An early diagnosis of GCM is crucial. Also, apart from standard heart failure therapy and physical rest a tailored immunosuppressive treatment may significantly alter the clinical course of the patients. The prognosis of patients with GCM is poor, and the probability of death or transplantation at 1 year from onset of symptoms is high [1,2]. Even after transplantation, there is a 20-25% GCM recurrence in the transplanted heart [4].