Time course of eosinophilic myocarditis visualized by CMR.
We report the diagnostic potential of cardiovascular magnetic resonance (CMR) to visualize the time course of eosinophilic myocarditis upon successful treatment. A 50-year-old man was admitted with a progressive heart failure. Endomyocardial biopsies were taken from the left ventricle because of a white blood cell count of 17000/mm3 with 41% eosinophils. Histological evaluation revealed endomyocardial eosinophilic infiltration and areas of myocyte necrosis. The patient was diagnosed with hypereosinophilic myocarditis due to idiopathic hypereosinophilic syndrome. CMR-studies at presentation and a follow-up study 3 weeks later showed diffuse subendocardial LGE in the whole left ventricle. Upon treatment with steroids, CMR-studies revealed marked reduction of subendocardial LGE after 3 months in parallel with further clinical improvement. This case therefore highlights the clinical importance of CMR to visualize the extent of endomyocardial involvement in the diagnosis and treatment of eosinophilic myocarditis.
Debl
Kurt
K
Klinik und Poliklinik für Innere Medizin II, Klinikum der Universität, Regensburg, Germany. kurt.debl@klinik.uni-regensburg.de
Djavidani
Behrus
B
Buchner
Stefan
S
Poschenrieder
Florian
F
Heinicke
Norbert
N
Feuerbach
Stefan
S
Riegger
Günter
G
Luchner
Andreas
A
D001707:Biopsy, Needle; D004802:Eosinophilia; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013997:Time Factors
D005938:Glucocorticoids