Eosinophilic Myocarditis Associated With Chronic Eosinophilic Leukemia

Eosinophilic myocarditis (EM) is a rare, dangerous complication of eosinophil-predominant disease. Its presentation varies greatly, with detrimental consequences including arrhythmia, heart failure, and sudden cardiac death.

A 58-year-old woman with chronic eosinophilic leukemia presented with worsening dyspnea and was found to have EM and left ventricular apical thrombus based on characteristic imaging findings. She was started on a heparin drip, corticosteroids, imatinib, and furosemide. She did not experience complications of myocarditis while admitted, and biventricular function was preserved.

There is a paucity of established guidelines regarding the diagnosis of EM. However, there may be a crucial role for imaging modalities in workup and diagnosis, one that may save patients from invasive procedures.

This case highlights the utility of noninvasive imaging as well as the importance of early recognition and multidisciplinary management. Clinicians should consider EM as part of the differential diagnosis when managing patients with eosinophilia and signs of cardiomyopathy.