Time course of eosinophilic myocarditis visualized by CMR

Kurt Debl¹ , Behrus Djavidani² , Stefan Buchner¹ , Florian Poschenrieder² , Norbert Heinicke¹ , Stefan Feuerbach² , Günter Riegger¹ and Andreas Luchner¹

¹Klinik und Poliklinik für Innere Medizin II, Klinikum der Universität, Regensburg, Germany

²Institut für Röntgendiagnostik, Klinikum der Universität, Regensburg, Germany

author email corresponding author email

Journal of Cardiovascular Magnetic Resonance 2008, 10:21doi:10.1186/1532-429X-10-21


Published:	8 May 2008

Abstract

We report the diagnostic potential of cardiovascular magnetic resonance (CMR) to visualize the time course of eosinophilic myocarditis upon successful treatment. A 50-year-old man was admitted with a progressive heart failure. Endomyocardial biopsies were taken from the left ventricle because of a white blood cell count of 17000/mm³with 41% eosinophils. Histological evaluation revealed endomyocardial eosinophilic infiltration and areas of myocyte necrosis. The patient was diagnosed with hypereosinophilic myocarditis due to idiopathic hypereosinophilic syndrome. CMR-studies at presentation and a follow-up study 3 weeks later showed diffuse subendocardial LGE in the whole left ventricle. Upon treatment with steroids, CMR-studies revealed marked reduction of subendocardial LGE after 3 months in parallel with further clinical improvement. This case therefore highlights the clinical importance of CMR to visualize the extent of endomyocardial involvement in the diagnosis and treatment of eosinophilic myocarditis.