[Hypereosinophilic syndrome associated with extensive asynergy of the left ventricular wall: a case report]

This is a report of a case of the hypereosinophilic syndrome associated with extensive asynergy of the left ventricular wall. This 41-year-old man's hospital admission in March, 1982 was for congestive heart failure, with marked eosinophilia (34%). Slight depression of the ST segments and flatness of the T waves were observed in electrocardiographic leads I, II, III, a VF, and V 5-6. Digitalis and diuretics were ineffective, but supplementary prednisone therapy resulted in a decrease in eosinophilia and improvement of congestive heart failure. He was transferred to our hospital for further examination in May, 1982. There were no signs of congestive heart failure, but a third heart sound was detected on admission. Marked ST segment depression and inverted T waves were observed in the left precordial leads. Echocardiography cardiography showed extensive asynergy of the left ventricular wall, and progressive enlargement of the left atrium and left ventricle. High density area near the apex of the left ventricle suggested the presence of mural thrombi. A left endocardial biopsy showed organized thrombi sparsely invaded by eosinophils. There were no signs nor symptoms of peripheral emboli. Tapering of the dose of prednisone was attempted twice, but each time eosinophilia resulted. The patient is now free of symptoms, and is being maintained on 25 mg of prednisone daily.