When multimodality cardiac imaging saves the day: rare cause of embolic strokes

Area of Science:

• Cardiology
• Hematology
• Neurology

Background:

• Hypereosinophilic syndrome (HES) is a rare disorder characterized by excessive eosinophils.
• Myocardial infiltration in HES can lead to Loeffler's endocarditis, causing endomyocardial injury.
• This injury can result in thrombus formation and embolic strokes.

Observation:

• A 57-year-old female presented with neurological symptoms suggestive of stroke.
• Investigations revealed multiple embolic strokes in a patient with a history of eosinophilia.
• Cardiac imaging confirmed Loeffler's endocarditis with left ventricular thrombus.

Findings:

• The patient was successfully treated with corticosteroids and anticoagulation therapy.
• Multimodality cardiac imaging played a critical role in diagnosis and monitoring.
• Understanding HES pathophysiology is key to managing associated cardiac complications.

Implications:

• This case highlights the importance of considering HES in patients with embolic strokes and eosinophilia.
• Prompt diagnosis and management of Loeffler's endocarditis can prevent further embolic events.
• Multimodality cardiac imaging is essential for accurate diagnosis and effective treatment monitoring in HES-related cardiac conditions.