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A hidden threat in the apical shadow: a case report regarding Loeffler endocarditis mimicking NSTEMI
Carlo Alberto Caruzzo1, Elia Rigamonti2, Francesca Romana Scopigni2
1Division of Cardiology, Ospedale La Carità, Ente Ospedaliero Cantonale, Via dell'Ospedale 1, Locarno 6600, Switzerland.
Background:
Loeffler endocarditis (LE) is a rare but potentially life-threatening cardiac manifestation of hyper-eosinophilic syndrome (HES). The disease is often complicated by intracardiac thrombus formation and may lead to severe restrictive cardiomyopathy and thromboembolic events.
Case Presentation:
We report the case of a 71-year-old man with long-standing idiopathic hyper-eosinophilia who presented with chest pain and progressive dyspnoea. Cardiac MRI revealed apical endocardial fibrosis with intracavitary thrombus, confirming a diagnosis of Loeffler endocarditis. The patient was successfully treated with corticosteroids and anticoagulation with vitamin K antagonists.
Conclusion:
This case highlights the diagnostic challenges and therapeutic strategies in managing LE. Cardiac MRI is essential for diagnosis, and early initiation of steroids and anticoagulation significantly improves clinical outcomes.
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