Cardiac involvement and left ventricular failure in a patient with the Churg-Strauss syndrome

The Churg-Strauss syndrome is characterised by a history of asthma and paranasal sinus disease, eosinophilia of more than 10 per cent, non-fixed pulmonary infiltrates on chest radiography and vasculitis which may affect multiple organ systems. The condition usually manifests in the 4th decade. We present a 21-year old female with a history of asthma since one year of age who developed symptoms and signs of pneumonia, a pulmonary infiltrate on chest radiography and eosinophilia. This was followed a few weeks later by vasculitis which affected the skin and myocardium and associated with a peripheral eosinophilia of more than 80%. Physical examination revealed palpable purpura and signs of left ventricular failure. Echocardiography confirmed significant diminution of left ventricular contractility. A rapid improvement was observed after steroid therapy. Echocardiography after two months showed normal left ventricular function. In this presentation we review the cardiac manifestations of the Churg-Strauss syndrome and its management.