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Published on: October 28, 2020
Eosinophilic myocarditis-an unusual cause of left ventricular hypertrophy
Samuel T Coffin1, Stewart M Benton, Daniel J Lenihan
1Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Insights
Eosinophilic myocarditis, a rare infiltrative cardiomyopathy, can mimic left ventricular hypertrophy. Prompt diagnosis and glucocorticoid therapy led to rapid improvement in a patient with acute heart failure.
Area of Science:
- Cardiology
- Pathology
Background:
- Eosinophilic myocarditis is a rare cardiac condition.
- It can present as infiltrative cardiomyopathy and left ventricular hypertrophy, posing diagnostic challenges.
Observation:
- A 79-year-old woman with a history of Non-Hodgkin's lymphoma presented with acute heart failure.
- Her presentation included significant left ventricular hypertrophy, prompting further investigation.
Findings:
- Echocardiography revealed infiltrative cardiomyopathy.
- Endomyocardial biopsy confirmed eosinophilic myocarditis.
Implications:
- Early diagnosis and treatment with glucocorticoids can lead to favorable outcomes.
- This case highlights the importance of considering eosinophilic myocarditis in cases of unexplained hypertrophy and heart failure.
Abstract:
Eosinophilic myocarditis is a rare condition in which inflammation of the heart results in an infiltrative cardiomyopathy that is often difficult to diagnose in the acute setting. It sometimes presents as left ventricular hypertrophy. The authors present a case of a 79-year-old woman with a history of Non-Hodgkin's lymphoma who presented with acute heart failure with marked left ventricular hypertrophy. Echocardiography demonstrated abnormalities consistent with an infiltrative cardiomyopathy, and endomyocardial biopsy showed findings consistent with eosinophilic myocarditis. The patient was managed with diuresis and glucocorticoid therapy, and within 4 weeks of her admission, her clinical status had improved and her echocardiogram normalized. The prompt diagnosis and treatment of this patient's myocarditis likely resulted in her favorable outcome. This illustrates the need for a broad consideration of all the potential causes of hypertrophy and the necessary diagnostic strategies and therapeutic options.
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