title: Unusual cause of acute mitral regurgitation: idiopathic hypereosinophilic syndrome.
abstract: Idiopathic hypereosinophilic syndrome (HES) is a rare multisystem condition characterized by dysregulated overproduction of eosinophils. Cardiac involvement in HES is characterized by necrosis from infiltration of eosinophils and thrombus formation and, in the late stage, by fibrosis and chronic valvular regurgitation. We report a very unusual presentation of idiopathic HES with acute mitral regurgitation due to papillary muscle rupture. The transesophageal echocardiogram was suggestive of a flail posterior leaflet and suspicious for endocarditis. Intraoperatively, papillary muscle rupture was seen and the patient underwent mitral valve replacement. The pathologic examination of the valve revealed eosinophilic infiltration of the papillary muscle. The patient was treated with steroids and responded well clinically.
authors.affiliation: Department of Cardiology, Case Medical Center, Cleveland, Ohio 44106, USA. surabhi.madhwal@uhhospitals.org
authors.forename: Surabhi
authors.initials: S
authors.lastname: Madhwal
authors.forename: Jonathan
authors.initials: J
authors.lastname: Goldberg
authors.forename: Julio
authors.initials: J
authors.lastname: Barcena
authors.forename: Avirup
authors.initials: A
authors.lastname: Guha
authors.forename: Prema
authors.initials: P
authors.lastname: Gogate
authors.forename: Brian
authors.initials: B
authors.lastname: Cmolik
authors.forename: Yakov
authors.initials: Y
authors.lastname: Elgudin
mesh_terms: D000208:Acute Disease; D000368:Aged; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications*; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology*