Eosinophilic myocarditis manifesting as myocardial infarction

Early diagnosis and successful treatment

L. Galiuto, Maurice E Sarano, G. S. Reeder, H. D. Tazelaar, J. T C Li, Fletcher A Jr. Miller, G. J. Gleich

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Objective: To report a case of eosinophilic myocarditis with remarkable initial clinical manifestations and outcome. Material and Methods: A 67- year-old woman with hypertension and a history of asthma and drug hypersensitivity was referred to our institution with a diagnosis of acute myocardial infarction on the basis of severe chest pain. ST elevation on an electrocardiogram, and a slight increase in cardiac enzymes. Further diagnostic studies were performed. Results: Echocardiography disclosed left ventricular dysfunction in conjunction with apical asynergy, thinning, and thrombus. The eosinophil count in the peripheral blood was increased only slightly. Coronary angiography showed normal arteries and prompted the performance of endomyocardial biopsy, which revealed active eosinophilic myocarditis. After corticosteroid therapy, global and regional left ventricular function returned to normal. Conclusion: This unusual clinical picture and outcome demonstrate that eosinophilic myocarditis may simulate acute myocardial infarction and should be considered in patients with a history of allergies or acute left ventricular dysfunction, even in the absence of pronounced eosinophilia in the peripheral blood. With appropriate medical therapy, recovery for these patients can be complete.

Original languageEnglish (US)
Pages (from-to)603-610
Number of pages8
JournalMayo Clinic Proceedings
Volume72
Issue number7
StatePublished - 1997

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Myocarditis
Early Diagnosis
Myocardial Infarction
Left Ventricular Dysfunction
Drug Hypersensitivity
Eosinophilia
Coronary Angiography
Chest Pain
Left Ventricular Function
Eosinophils
Echocardiography
Adrenal Cortex Hormones
Hypersensitivity
Electrocardiography
Thrombosis
Therapeutics
Asthma
Arteries
Hypertension
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Eosinophilic myocarditis manifesting as myocardial infarction : Early diagnosis and successful treatment. / Galiuto, L.; Sarano, Maurice E; Reeder, G. S.; Tazelaar, H. D.; Li, J. T C; Miller, Fletcher A Jr.; Gleich, G. J.

In: Mayo Clinic Proceedings, Vol. 72, No. 7, 1997, p. 603-610.

Research output: Contribution to journalArticle

Galiuto, L. ; Sarano, Maurice E ; Reeder, G. S. ; Tazelaar, H. D. ; Li, J. T C ; Miller, Fletcher A Jr. ; Gleich, G. J. / Eosinophilic myocarditis manifesting as myocardial infarction : Early diagnosis and successful treatment. In: Mayo Clinic Proceedings. 1997 ; Vol. 72, No. 7. pp. 603-610.
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