Eosinophilic myocarditis: an often subtle and potentially under-recognised phenomenon.
John Joseph CoughlanGerald Paul FitzgeraldFilza GulRichard ListonPublished in: BMJ case reports (2017)
A 34-year-old woman presented to our service with chest pain, a troponin rise and dynamic ECG changes. Of note, she had complained of fatigue, feeling constitutionally unwell and a generalised rash in the days prior to her presentation. Her echocardiogram showed normal wall motion and preserved ejection fraction. Her eosinophil count, normal at presentation, rose to a peak of 12.21×105/L. She was haemodynamically stable throughout with no evidence clinically of congestive cardiac failure. CT coronary angiogram showed no obstructive coronary artery disease. Cardiac MRI demonstrated areas of late gadolinium enhancement consistent with myocarditis. A diagnosis of eosinophilic myocarditis was made. No tissue biopsy was performed due to the patchy myocardial involvement and high potential for low-yield biopsy. Our patient was treated conservatively and has made an excellent recovery.
Keyphrases
- ejection fraction
- coronary artery disease
- aortic stenosis
- left ventricular
- contrast enhanced
- case report
- chronic rhinosinusitis
- magnetic resonance imaging
- ultrasound guided
- fine needle aspiration
- mental health
- healthcare
- percutaneous coronary intervention
- coronary artery
- coronary artery bypass grafting
- magnetic resonance
- transcatheter aortic valve replacement
- type diabetes
- cardiovascular events
- heart failure
- image quality
- cardiovascular disease
- heart rate
- heart rate variability
- aortic valve
- peripheral blood
- sleep quality
- dual energy
- risk assessment
- high resolution
- mass spectrometry
- high speed