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 con...

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Bibliographic Details
Published in:Heart & lung 2015-03, Vol.44 (2), p.165-169
Main Authors: Zhuang, Qin, MMed, Zheng, Zhi-yin, MD, Mao, Wei, MD, Dong, Bei-li, MMed, Yang, Bing-sheng, MMed, Ni, Gui-bao, MMed, Xu, Qing-yun, MMed, Xu, Yi-fei, MMed
Format: Article
Language:English
Subjects:
Aged
Blood diseases
Cardiac arrhythmia
Cardiovascular
Corticosteroids
Critical Care
Drug therapy
Echocardiography
Endocardial thickening
Endocarditis
Heart Atria - pathology
Heart failure
Heart Failure - diagnosis
Heart Ventricles - pathology
Humans
Hypereosinophilic Syndrome - diagnosis
Idiopathic hypereosinophilic syndrome
Imatinib
Magnetic Resonance Imaging
Male
Medical prognosis
NMR
Nuclear magnetic resonance
Pathology
Pulmonary/Respiratory
Thrombosis - diagnosis
Thrombus
Vena Cava, Superior - pathology
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Summary: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.
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2014.11.003