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Idiopathic eosinophilic endomyocarditis in the absence of peripheral eosinophilia
Ute Priglinger1, Johannes Drach, Robert Ullrich
1Department of Cardiology, University of Vienna Medical School, Austria. ute.priglinger@univie.ac.at
Insights
Eosinophilic endomyocarditis can occur without high blood eosinophil counts. Endomyocardial biopsy is crucial for diagnosing this heart condition in patients with unexplained heart failure or ventricular fibrillation.
Area of Science:
- Cardiology
- Pathology
- Oncology
Background:
- Eosinophilic endomyocarditis is a rare cardiac condition.
- It is often associated with hypereosinophilia.
Observation:
- Two patients, a 69-year-old male and a 16-year-old female, presented with unusual manifestations of eosinophilic endomyocarditis.
- Both patients had normal blood eosinophil counts at symptom onset.
- The male patient had a history of heart failure and ventricular fibrillation.
- The female patient experienced ventricular fibrillation and ECG findings suggestive of acute myocardial infarction.
Findings:
- Absence of hypereosinophilia does not rule out eosinophilic organ infiltration.
- Endomyocardial biopsy is essential for diagnosis.
Implications:
- This case report highlights the importance of considering eosinophilic endomyocarditis even with normal eosinophil counts.
- Endomyocardial biopsy may be the definitive diagnostic tool for unexplained heart failure or ventricular fibrillation.
- Early diagnosis and treatment can potentially improve patient outcomes in eosinophilic endomyocarditis.
Abstract:
In this case report we present two patients with unusual manifestations of eosinophilic endomyocarditis: A 69-year-old patient with a history of heart failure and ventricular fibrillation and a 16-year-old woman with ventricular fibrillation and an ECG indicating acute myocardial infarction had both normal blood eosinophil counts at the onset of symptoms. The absence of hypereosinophilia, therefore, does not exclude the presence of eosinophilic organ infiltration. Endomyocardial biopsy may be the only diagnostic procedure to identify necrotic eosinophilic endomyocarditis in patients with unexplained heart failure or ventricular fibrillation.