Biventricular assist device placement and immunosuppression as therapy for necrotizing eosinophilic myocarditis

A previously healthy 47-year-old woman presented reporting nausea, anorexia and light-headedness of 2 weeks' duration, and three episodes of syncope. She also had pleuritic chest pain and rapidly declining cardiac function. The only reported medical history was urinary tract infection and an ankle fracture sustained 5 months before presentation. She was receiving no medication other than estrogen patches for menopause and did not smoke or use illicit drugs.

Electrocardiography, chest radiography, echocardiography, measurement of creatinine phosphokinase and troponin T, coronary angiography and endomyocardial biopsy.

Necrotizing eosinophilic myocarditis.

Biventricular assist device implantation, methylprednisolone, prednisolone and mycophenolate mofetil.