Acute eosinophilic endomyocarditis: early diagnosis and localisation of the lesion by cardiac magnetic resonance imaging

Looi, J.; Ruygrok, Peter; Royle, Gordon; Raos, Zoe; Hood, Chris; Kerr, Andrew

doi:10.1007/s10554-009-9580-9

Cited by 13 publications

(7 citation statements)

References 7 publications

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“…In fact, different scenarios have been reported in the course of active myocarditis in HES including the complete resolution of myocarditis and persistence of LGE lesions in the myocardium. 10,28,36 In addition, both scenarios were also observed in other types of myocardial inflammation, including vasculitis and viral etiology, and were linked to prognosis. 31,32 Prior case reports documented the ability of CMR to depict eosinophilic myocarditis in HES confirmed by endomyocardial biopsy.…”

Section: Discussionmentioning

confidence: 96%

MRI-based Evidence for Myocardial Involvement in Women with Hypereosinophilic Syndrome

et al. 2015

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Purpose: The aim of the study was to assess the presence and spectrum of cardiac abnormalities identified by cardiac magnetic resonance (CMR) in women with hypereosinophilic syndrome (HES) of undefined etiology, who present with normal electrocardiography (ECG) and transthoracic echocardiography (TTE) and no history of heart disease.Methods: Ten women (mean age, 48 « 14 years) with HES of undefined etiology, normal ECG and TTE, and no history of heart disease underwent CMR.Results: CMR showed cardiac abnormalities in 6 subjects. Five patients had nonischemic late gadolinium enhancement (LGE) lesions within the left ventricular (LV) myocardium, and 3 patients demonstrated CMR evidence of myocardial inflammation. The LV ejection fraction was 68.5 « 5.7%, and the end-diastolic volume index was 62.7 « 14.7 mL/m 2 . The maximum measured blood eosinophil count correlated with LVLGE volume (r = 0.80, P = 0.006) and was 11374 « 6242 cells/µL and 4114 « 2972 cells/µL (P = 0.047) in patients with and without LGE lesions, respectively. The actual blood eosinophil count in subjects with and without CMR evidence of myocarditis was 1058 « 520 cells/µL and 354 « 377 cells/µL (P = 0.04), respectively.Conclusions: Despite normal ECG, TTE, and absence of history of heart disease, women with HES of unknown etiology frequently demonstrate cardiac abnormalities on CMR, the presence and extent of which are related to blood eosinophil count.

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Section: Discussionmentioning

confidence: 96%

MRI-based Evidence for Myocardial Involvement in Women with Hypereosinophilic Syndrome

et al. 2015

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“…It is estimated that the sensitivity of biopsy is around 54% [7]. As demonstrated by Looi et al, the use of CMR assists in the early diagnosis of the disease and the initiation of appropriate therapy [13].…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Myocarditis: An Often-Overlooked Diagnosis in Patients Presenting with Heart Failure

Cho

Asreb

Mahmood

et al. 2022

Case Reports in Cardiology

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Introduction. Hypereosinophilic syndrome (HES) is a rare disease characterized by unexplained peripheral eosinophilia along with evidence of end-organ damage. Cardiac involvement is the most life-threatening consequence and is frequently underreported with a prevalence of around 5%. The gold standard for diagnosis is myocardial biopsy, but less-invasive imaging such as cardiac MR (CMR) has been frequently used to help with the diagnosis. We are presenting a unique case of a patient diagnosed with Eosinophilic myocarditis (EM) supported by CMR with rapid improvement after starting steroid treatment. Case Presentation. A 67-year-old African American female with extensive cardiovascular disease history presenting with chest pain was diagnosed with EM secondary to hypereosinophilic syndrome (HES). Lab workup revealed absolute eosinophils of 4.70 × 10 3 / μ L (normal 0 – 0.75 × 10 3 / μ L ). Transthoracic echocardiography showed mild reduction in left ventricular function and a large obliterating thrombus in the right ventricular apex. CMR showed increased signal intensity at the left ventricular and right ventricular apex, consistent with myocardial edema. Subsequently, the patient was placed on dexamethasone 10 mg daily with significant symptomatic improvement. Discussion. EM is a rare complication of hypereosinophilic syndrome and can mimic common cardiovascular diseases such as acute exacerbation of heart failure or myocardial infarction. A high index of suspicion is essential especially in the setting of suggestive lab workup. CMR is a promising noninvasive and cost-effective alternative for myocardial biopsy in diagnosis.

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“… 6 , 11 CMR, however, can reliably detect all stages of the disease process and all areas of myocardium involved, with serial CMR allowing disease monitoring and response to treatment, as was the case in our patient. 12 …”

Section: Discussionmentioning

confidence: 99%

Intracardiac Thrombus in Leukemia: Role of Cardiac Magnetic Resonance Imaging in Eosinophilic Myocarditis

Allderdice

Marcu

Kabirdas

2018

CASE

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Acute eosinophilic endomyocarditis: early diagnosis and localisation of the lesion by cardiac magnetic resonance imaging

Cited by 13 publications

References 7 publications

MRI-based Evidence for Myocardial Involvement in Women with Hypereosinophilic Syndrome

MRI-based Evidence for Myocardial Involvement in Women with Hypereosinophilic Syndrome

Eosinophilic Myocarditis: An Often-Overlooked Diagnosis in Patients Presenting with Heart Failure

Intracardiac Thrombus in Leukemia: Role of Cardiac Magnetic Resonance Imaging in Eosinophilic Myocarditis

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