What's behind your eosinophilic myocarditis? A case of Churg-Strauss syndrome diagnosed during acute heart failure.
Nicola AmelottiMassimo MapelliMarco GuglielmoMaria Inês Fiuza Branco PiresJeness CampodonicoBenedetta MajocchiValentina RibattiGiulia VettorAndrea BaggianoValentina CattoCristina BassoGianluca PontonePiergiuseppe AgostoniPublished in: ESC heart failure (2022)
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystem disorder; cardiac involvement may include eosinophilic myocarditis. A 67-year-old woman presented with 1-week history of dyspnoea and orthopnoea. She had a history of adult-onset asthma and peripheral eosinophilia. The investigations showed T-wave inversion on lateral leads, peripheral eosinophilia, elevated troponin and BNP values, and severe biventricular systolic dysfunction with diffuse hypokinesia and apical akinesia. Computed tomography excluded coronary disease and showed bilateral basal ground-glass opacities, air-space consolidation, and bilateral reticular-nodular pattern. Cardiac magnetic resonance findings were compatible with active myocardial inflammation. An endomyocardial biopsy (EMB) confirmed the diagnosis of eosinophilic myocarditis, and a therapy with oral corticosteroids and heart failure medications was started.
Keyphrases
- left ventricular
- heart failure
- acute heart failure
- chronic rhinosinusitis
- magnetic resonance
- computed tomography
- cardiac resynchronization therapy
- oxidative stress
- contrast enhanced
- case report
- aortic stenosis
- blood pressure
- coronary artery disease
- magnetic resonance imaging
- coronary artery
- chronic obstructive pulmonary disease
- lung function
- chemotherapy induced
- minimally invasive
- randomized controlled trial
- early onset
- ultrasound guided
- positron emission tomography
- stem cells
- aortic valve
- high grade