title: Hypersensitivity myocarditis complicating hypertrophic cardiomyopathy heart.
abstract: 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.
authors.affiliation: Department of Pathology, Toronto General Hospital, Toronto, Ontario. jagdish.butany@uhn.on.ca
authors.forename: Jagdish
authors.initials: J
authors.lastname: Butany
authors.forename: Vidhya
authors.initials: V
authors.lastname: Nair
authors.forename: Manmeet S
authors.initials: MS
authors.lastname: Ahluwalia
authors.forename: James
authors.initials: J
authors.lastname: Graba
authors.forename: Dina
authors.initials: D
authors.lastname: El Demellawy
authors.forename: Vivek
authors.initials: V
authors.lastname: Rao
authors.forename: Heather
authors.initials: H
authors.lastname: Ross
mesh_terms: 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
chemical_list: D000318:Adrenergic beta-Agonists; D004280:Dobutamine