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Case Reports
. 2021 Mar 17;3(3):474-478.
doi: 10.1016/j.jaccas.2020.12.028. eCollection 2021 Mar.

Fulminant Eosinophilic Myocarditis and VT Storm

Kyle R Hoppens  1 , Hamid R Alai  2 , Jelena Surla  1 , Hina O Khokhar  3 , Robert C Hendel  2
Affiliations
Case Reports

Fulminant Eosinophilic Myocarditis and VT Storm

Kyle R Hoppens et al. JACC Case Rep. .

Abstract

Eosinophilic myocarditis is a rare and frequently fatal disease that is often undiagnosed until autopsy. We report a case of eosinophilic myocarditis with an unusual initial presentation of palpitations that subsequently evolved into ventricular tachycardia storm and death within 4 days. (Level of Difficulty: Beginner.).

Keywords: EM, eosinophilic myocarditis; PVC, pre-mature ventricular contractions; VF, ventricular fibrillation; VT, ventricular tachycardia; eosinophilic myocarditis; palpitations; polymorphic pre-mature ventricular contractions; ventricular tachycardia storm.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Electrocardiogram at Presentation Sinus tachycardia at a rate of 113 beats/min with frequent polymorphic PVCs. A sinus beat (gray arrow) and 2 different PVC morphologies (black and white arrows), both likely originating from the posterobasal or posteromedial left ventricle, are highlighted (10).
Figure 2
Figure 2
Transthoracic Echocardiogram (A) End-diastolic and (B) end-systolic frames of the parasternal long-axis view. Left and right ventricular function and wall thickness were normal, with left ventricular basal anteroseptal hypokinesis.
Figure 3
Figure 3
Polar Plot of Peak Longitudinal Strain Speckle-tracking peak global longitudinal strain of the left ventricle is reduced at -11% with an exaggerated apical sparing pattern. ANT = anterior; INF = inferior; LAT = lateral; POST = posterior; SEPT = septal.
Figure 4
Figure 4
Rhythm Strip Rhythm strip before cardiac arrest with R-on-T phenomenon (black arrow) triggering ventricular tachycardia.
Figure 5
Figure 5
Autopsy Histopathology (Hematoxylin and Eosin) Cardiac myocytes with interstitial inflammatory infiltrate composed of numerous eosinophils (black arrow) and occasional mast cells throughout the left and right ventricular myocardium, consistent with eosinophilic myocarditis with minimal necrosis.
See this image and copyright information in PMC

References

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