title: Right ventricular apical obstruction in a patient with hypereosinophilia: Löffler endocarditis.
abstract: Idiopathic hypereosinophilic syndrome (HES) is a rare leukoproliferative systemic disorder characterized by sustained overproduction of eosinophils and poor prognosis. A case that a 67-year-old man with persistent symptoms of heart failure due to cardiac involvement in idiopathic HES is concentrated on. Echocardiography revealed the marked endocardial thickening of both ventricles with an apical obstruction of the right ventricle. Medical therapy, including low dose dopamine and furosemidum, was initiated with corticosteroids, imatinib and hydroxycarbamide. Remission of symptoms had persisted for only 3 weeks. As the count of eosinophils rebounded, the patient suffered with refractory heart failure, severe hypoxemia and acute renal insufficiency, eventually died 62 days after his hospitalization. The rechecking of his last MRI showed thrombus both in right atrium and superior vena cava, which indicated that he might have died of pulmonary embolism, besides the refractory heart failure and multiple organ failure.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhuang
authors.affiliation: Department of Hematology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
authors.forename: Zhi-yin
authors.initials: ZY
authors.lastname: Zheng
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China. Electronic address: maoweilw@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Mao
authors.affiliation: Department of Ultrasound, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
authors.forename: Bei-li
authors.initials: BL
authors.lastname: Dong
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
authors.forename: Bing-sheng
authors.initials: BS
authors.lastname: Yang
authors.affiliation: Department of Pathology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
authors.forename: Gui-bao
authors.initials: GB
authors.lastname: Ni
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
authors.forename: Qing-yun
authors.initials: QY
authors.lastname: Xu
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
authors.forename: Yi-fei
authors.initials: YF
authors.lastname: Xu
mesh_terms: D000368:Aged; D004452:Echocardiography; D006325:Heart Atria / Q000473:pathology; D006333:Heart Failure / Q000175:diagnosis*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D013927:Thrombosis / Q000175:diagnosis*; D014683:Vena Cava, Superior / Q000473:pathology
keywords: Corticosteroids; Endocardial thickening; Endocarditis; Idiopathic hypereosinophilic syndrome; Imatinib; Thrombus