Hypersensitivity myocarditis complicating hypertrophic cardiomyopathy heart.
The present report describes a case of eosinophilic myocarditis complicating hypertrophic cardiomyopathy. The 47-year-old female patient, known to have hypertrophic cardiomyopathy, was admitted with biventricular failure and managed aggressively with dobutamine infusion and other drugs while being assessed for heart transplantation. On transthoracic echocardiogram, she had moderate left ventricular dysfunction with regional variability and moderate mitral regurgitation. The recipient's heart showed the features of apical hypertrophic cardiomyopathy and myocarditis with abundant eosinophils. Myocarditis is rare and eosinophilic myocarditis is rarer. It is likely that the hypersensitivity (eosinophilic) myocarditis was related to dobutamine infusion therapy. Eosinophilic myocarditis has been reported with an incidence of 2.4% to 7.2% in explanted hearts and may be related to multidrug therapy.
Butany
Jagdish
J
Department of Pathology, Toronto General Hospital, Toronto, Ontario. jagdish.butany@uhn.on.ca
Nair
Vidhya
V
Ahluwalia
Manmeet S
MS
Graba
James
J
El Demellawy
Dina
D
Rao
Vivek
V
Ross
Heather
H
D000318:Adrenergic beta-Agonists / Q000009:adverse effects; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D004280:Dobutamine / Q000009:adverse effects; D004342:Drug Hypersensitivity; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D009205:Myocarditis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology
D000318:Adrenergic beta-Agonists; D004280:Dobutamine