What's behind your eosinophilic myocarditis? A case of Churg–Strauss syndrome diagnosed during acute heart failure

Nicola Amelotti, Massimo Mapelli*, Marco Guglielmo, Maria Inês Fiuza Branco Pires, Jeness Campodonico, Benedetta Majocchi, Valentina Ribatti, Giulia Vettor, Andrea Baggiano, Valentina Catto, Cristina Basso, Gianluca Pontone, Piergiuseppe Agostoni

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystem disorder; cardiac involvement may include eosinophilic myocarditis. A 67-year-old woman presented with 1-week history of dyspnoea and orthopnoea. She had a history of adult-onset asthma and peripheral eosinophilia. The investigations showed T-wave inversion on lateral leads, peripheral eosinophilia, elevated troponin and BNP values, and severe biventricular systolic dysfunction with diffuse hypokinesia and apical akinesia. Computed tomography excluded coronary disease and showed bilateral basal ground-glass opacities, air-space consolidation, and bilateral reticular-nodular pattern. Cardiac magnetic resonance findings were compatible with active myocardial inflammation. An endomyocardial biopsy (EMB) confirmed the diagnosis of eosinophilic myocarditis, and a therapy with oral corticosteroids and heart failure medications was started.

Original languageEnglish
Pages (from-to)709-715
Number of pages7
JournalESC heart failure
Volume10
Issue number 1
DOIs
Publication statusPublished - Feb 2023

Keywords

  • Cardiac magnetic resonance
  • Endomyocardial biopsy
  • Eosinophilic granulomatosis with polyangiitis (Churg–Strauss)
  • Eosinophilic myocarditis
  • Heart failure

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