Ventricular tachycardia as the first manifestation of Churg-Strauss syndrome
Margarita Budanova1, Lubov Mitrofanova1, Andrey Kozlenok1
1Federal Almazov North-West Medical Research Centre, St. Petersburg, Russia.
Insights
Life-threatening ventricular arrhythmias are rare symptoms of Churg-Strauss syndrome. This case highlights cardiac issues as primary signs, aiding differential diagnosis with IgG4-related diseases.
Area of Science:
- Cardiology
- Rheumatology
- Pathology
Background:
- Churg-Strauss syndrome, now known as eosinophilic granulomatosis with polyangiitis, typically presents with asthma and eosinophilia.
- Cardiac involvement in Churg-Strauss syndrome is common but usually manifests as cardiomyopathy or heart failure, not as primary arrhythmias.
Observation:
- A 66-year-old woman presented with symptomatic monomorphic ventricular tachycardia as the initial clinical manifestation.
- Cardiac symptoms were predominant, with minimal involvement observed in other organs.
- Elevated serum IgG4 levels complicated the differential diagnosis, prompting consideration of IgG4-related diseases.
Findings:
- Diagnostic imaging, including echocardiography and cardiac magnetic resonance imaging, was crucial.
- Histopathological analysis of biopsy samples confirmed the diagnosis.
- The case underscores the importance of considering Churg-Strauss syndrome in patients with unexplained ventricular arrhythmias.
Implications:
- This case expands the known clinical spectrum of Churg-Strauss syndrome.
- It emphasizes the need for a broad differential diagnosis in patients presenting with cardiac arrhythmias.
- Early recognition and diagnosis of cardiac manifestations in Churg-Strauss syndrome are vital for timely management.
Abstract:
Life-threatening arrhythmias are often found in heart diseases, but they are rare as clinical symptoms of Churg-Strauss syndrome. We report a case of a 66-year-old woman with symptomatic monomorphic ventricular tachycardia as the first sign of Churg-Strauss syndrome. Cardiac manifestations were the main clinical symptoms of the disease, and changes in other organs were weakly expressed. Furthermore, increased serum IgG4 level was revealed. It was the reason for the differential diagnosis with IgG4-related diseases. Echocardiography, cardiac magnetic resonance imaging, and histopathological analysis of biopsies had an important role in diagnosis. <Learning objective: Ventricular arrhythmias are rare clinical symptoms of Churg-Strauss syndrome. This case is interesting because cardiac manifestations were the main clinical symptom of the disease, and changes in other organs were weakly expressed. Echocardiography, cardiac magnetic resonance imaging, and histopathological analysis of biopsies had an important role in diagnosis. Increased serum IgG4 level was the reason for the differential diagnosis with IgG4-related diseases. Churg-Strauss syndrome should be considered as part of the differential diagnosis in patients with noncoronary ventricular arrhythmias.>.
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