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Churg-Strauss syndrome associated with rapid deterioration of left ventricular diastolic dysfunction and conduction

Jung Yeon Chin1, Jeong Eun Yi, Ho-Joong Youn

  • 1Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Echocardiography (Mount Kisco, N.Y.)
|July 31, 2013
PubMed

Insights

Churg-Strauss syndrome (CSS) can cause fatal eosinophilic endomyocarditis. This case highlights rapid worsening of heart dysfunction and conduction issues despite treatment for hypereosinophilia.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pathology

Background:

  • Cardiac involvement in Churg-Strauss syndrome (CSS) significantly increases mortality risk.
  • Eosinophilic endomyocarditis is a rare but severe manifestation of CSS.

Observation:

  • A 75-year-old woman presented with symptoms suggestive of cardiac compromise.
  • Diagnostic workup revealed intraventricular conduction delay, impaired biventricular diastolic function, apical thickening, and thrombi.

Findings:

  • Endomyocardial biopsy confirmed eosinophilic infiltration, indicative of eosinophilic endomyocarditis secondary to CSS.
  • Despite successful steroid treatment for hypereosinophilia, left ventricular diastolic function rapidly progressed to a restrictive pattern.
  • The patient developed a ventricular escape rhythm and died on day 14.

Implications:

  • This case underscores the potential for rapid and fatal cardiac deterioration in CSS-related eosinophilic endomyocarditis.
  • Early recognition and aggressive management of cardiac manifestations are crucial for improving outcomes in CSS patients.
  • The rapid progression of diastolic dysfunction and conduction abnormalities presents a unique challenge in managing this condition.

Keywords:
Churg-Strauss syndromecardiac conduction defectleft ventricular dysfunction

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