Echo Research and Practice (Feb 2020)

Idiopathic eosinophilic myocarditis presenting with features of an acute coronary syndrome

  • Nam Tran,
  • Chun Shing Kwok,
  • Sadie Bennett,
  • Karim Ratib,
  • Grant Heatlie,
  • Thanh Phan

DOI
https://doi.org/10.1530/erp-19-0044
Journal volume & issue
Vol. 7, no. 1
pp. K1 – K6

Abstract

Read online

A 62-year-old female was admitted with severe left-sided chest pain, nausea and pre-syncope. She had widespread T wave inversion on ECG and elevated troponins and was suspected to have an acute coronary syndrome event. Invasive coronary angiogram revealed normal coronary anatomy with no flow-limiting lesions. Echocardiography and cardiac MRI revealed impaired left ventricular (LV) systolic impairment, a mobile LV apical thrombus and a moderate global pericardial effusion with no significant compromise. Full blood count analysis indicated the patient to have significant eosinophilia, and the patient was diagnosed with idiopathic eosinophilic myocarditis. She was commenced on Prednisolone and Apixaban, and eosinophil levels returned to normal after 10 days of steroids. Over the course of 3 months, the patient had a complete recovery of her LV function and resolution of the LV thrombus. This case highlights a rare, reversible case of idiopathic eosinophilic myocarditis which may present similar to acute coronary syndrome.

Keywords