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Eosinophilic myocarditis in dilated cardiomyopathy: a case report
1Department of Hematology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
BMC Cardiovascular Disorders
|May 7, 2025
Summary
Eosinophilic myocarditis (EM) is challenging to diagnose, even with biopsies. Heart transplantation confirmed EM in a patient with dilated cardiomyopathy when initial biopsies were negative, highlighting its diagnostic value.
Area of Science:
- Cardiology
- Pathology
Background:
- Eosinophilic myocarditis (EM) is a rare and difficult-to-diagnose cardiac condition.
- Endocardial myocardial biopsy, the gold standard, can yield false-negative results due to sampling errors.
Purpose of the Study:
- To report a case of dilated cardiomyopathy in a patient with EM.
- To highlight diagnostic challenges and the role of heart transplantation in confirming EM.
Main Methods:
- Clinical presentation of a 32-year-old female with suspected EM based on eosinophilia and eosinophilic pneumonia.
- Diagnostic workup including endocardial myocardial biopsy, which was initially negative.
- Treatment with various interventions, ECMO, and IABP without significant improvement.
- Confirmation of EM through pathology after heart transplantation.
Main Results:
- Initial endocardial myocardial biopsy failed to confirm EM.
- Patient showed minimal improvement despite aggressive medical and mechanical support.
- Heart transplantation provided definitive diagnosis, revealing significant eosinophilic infiltration.
Conclusions:
- Endocardial myocardial biopsy can be falsely negative in diagnosing EM.
- Heart transplantation can serve as a crucial diagnostic tool for EM when other methods fail.
- Pathological examination of explanted heart tissue confirmed EM in this case.
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