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A 50-year-old man with eosinophilia and cardiomyopathy: need for endomyocardial biopsy?

Lars Aakerøy1, Brage Høyem Amundsen, Johan Fredrik Skomsvoll

  • 1Department of Cardiology, St Olavs University Hospital,Trondheim, Norway. lars.aakeroy@stolav.no

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|December 9, 2010
PubMed

Insights

A man with suspected heart attack had normal coronary angiogram but was diagnosed with Churg-Strauss syndrome causing perimyocarditis. This case highlights diagnostic challenges in cardiac manifestations of eosinophilic granulomatosis with polyangiitis.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pathology

Background:

  • Acute coronary syndrome is a common presentation for cardiac emergencies.
  • Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis, is a rare systemic vasculitis.

Observation:

  • A 50-year-old male presented with symptoms suggestive of acute coronary syndrome.
  • Coronary angiography revealed no significant blockages.
  • The patient exhibited cardiomyopathy and peripheral eosinophilia.

Findings:

  • The diagnosis was perimyocarditis secondary to Churg-Strauss syndrome.
  • Eosinophilic infiltration of the myocardium is a known, though uncommon, feature of this syndrome.

Implications:

  • This case underscores the importance of considering systemic inflammatory conditions in patients with cardiac symptoms and eosinophilia.
  • The diagnostic utility and timing of endomyocardial biopsy in such presentations warrant further discussion.

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