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Case Reports
. 2009;36(4):355-7.

Acute eosinophilic myocarditis mimicking myocardial infarction

Senthil K Thambidorai  1 , Hema L Korlakunta, Amy J Arouni, William J Hunter, Mark J Holmberg
Affiliations
Case Reports

Acute eosinophilic myocarditis mimicking myocardial infarction

Senthil K Thambidorai et al. Tex Heart Inst J. 2009.

Abstract

Eosinophilic myocarditis is characterized by progressive myocardial damage that results in heart failure and death. Herein, we present the case of a 54-year-old man who presented with symptoms of acute myocardial infarction. Normal coronary angiographic results and the presence of elevated levels of peripheral-blood eosinophilia prompted an endomyocardial biopsy that revealed acute eosinophilic myocarditis. The early initiation of steroid therapy resulted in the patient's substantial clinical improvement and survival. Early diagnosis of eosinophilic myocarditis and its treatment with steroid agents in some patients can lead to a favorable outcome. We discuss the challenge of diagnosing and identifying the characteristics of this variant of necrotizing eosinophilic myocarditis before the condition proves fatal.

Keywords: Acute disease; biopsy; diagnosis, differential; eosinophilia/etiology/pathology/therapy; heart failure/etiology; immunosuppressive agents/therapeutic use; myocarditis/classification/diagnosis/drug therapy/etiology/pathology; necrosis; prednisone/therapeutic use.

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Figures

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Fig. 1 Transthoracic echocardiography of the left ventricle shows increased septal wall thickness.
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Fig. 2 Histographic endomyocardial biopsy shows eosinophilic infiltration into the myocardial interstitium (H & E, orig. ×1,000).
See this image and copyright information in PMC

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