Severe mitral stenosis secondary to eosinophilic granulomatosis resolving after pharmacological treatment

Abstract

We present a case of 44‐year‐old woman who underwent effective pharmacological treatment of severe mitral stenosis. The patient was hospitalized due to rapidly progressive dyspnea. Her medical history included asthma, perennial rhinitis, and nasal polyps. Echocardiography showed a mass of the left ventricle involving the mitral valve; cardiac MRI suggested acute endocarditis. Severe peripheral blood eosinophilia was found. Eosinophilic granulomatosis with polyangiitis was diagnosed; treatment with prednisone and cyclophosphamide was started. Despite the clinical improvement, severe mitral stenosis persisted, surgical treatment was planned. However, evaluation after 6 cycles of cyclophosphamide pulse therapy revealed a significant regression of the valvular disease.

Eosinophilic Myocarditis: From Bench to Bedside

“…The presence of an intracavitary thrombus could be assessed, given the pro-thrombotic status, as previously said [ 3 , 17 ]. Interestingly, in the last few years, several studies have described acute valvulopathy secondary to EM, including a case of severe mitral stenosis secondary to EGPA that resolved after pharmacological treatment [ 63 ]. In addition, mitral and tricuspid regurgitation are more common echocardiographic findings, probably related to inflammatory damage [ 64 ].…”