Rapid normalization of vasculitis-induced left ventricular dysfunction related with multiple cardiac thrombi

Area of Science:

• Cardiology
• Rheumatology
• Pathology

Background:

• Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis, is a rare autoimmune disorder.
• It typically affects the respiratory system and can involve multiple organs, including the heart.

Observation:

• A young female presented with acute heart failure, including pulmonary edema and severely impaired left ventricular function.
• Echocardiography revealed simultaneous intracardiac thrombi in both ventricles and the right atrium.
• Cardiac magnetic resonance imaging demonstrated significant myocardial edema and diffuse gadolinium enhancement, alongside an elevated peripheral eosinophil count.

Findings:

• The patient received treatment with corticosteroids and cyclophosphamide for suspected Churg-Strauss syndrome.
• Within three months, there was a remarkable normalization of left ventricular function.
• Intracardiac thrombi and myocardial edema resolved completely following treatment.

Implications:

• This case highlights the potential for severe cardiac manifestations in Churg-Strauss syndrome.
• Early diagnosis and aggressive immunosuppressive therapy can lead to significant cardiac recovery.
• Highlights the importance of considering cardiac involvement in eosinophilic disorders.