• Ryu Kazama, Yuji Okura, Makoto Hoyano, Ken Toba, Yukie Ochiai, Noriko Ishihara, Takashi Kuroha, Tsuyoshi Yoshida, Osamu Namura, Masakazu Sogawa, Yuichi Nakamura, Nobuhiko Yoshimura, Ken Nishikura, Kiminori Kato, Haruo Hanawa, Yusuke Tamura, Shinichiro Morimoto, Makoto Kodama, and Yoshifusa Aizawa.
• Division of Cardiology, Hematology and Endocrinology/ Metabolism Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
• Mayo Clin. Proc. 2003 Jul 1; 78 (7): 901-7.

AbstractWe describe a patient with acute necrotizing eosinophilic myocarditis who recovered rapidly after pericardial drainage and without corticosteroid therapy. The 25-year- old man was referred to our hospital with suspected acute myocardial infarction on the basis of severe epigastralgia, abnormal Q waves and ST elevation on electrocardiography, and an increase in cardiac enzymes. Echocardiography disclosed pericardial effusion that compressed the right ventricle, left ventricular dysfunction in conjunction with posterolateral hypokinesis, and a thickened ventricular wall but no mural thrombus. The eosinophil count in the peripheral blood was slightly increased. Coronary angiography showed normal arteries and thus prompted an endomyocardial biopsy. The patient was transferred to the intensive care unit with a clinical diagnosis of myocarditis associated with cardiac tamponade. Emergency pericardiocentesis relieved symptoms immediately. The cells in the pericardial effusion were mainly eosinophils; interleukin 5 and interleukin 13 levels were predominantly elevated, and the effusion was drained for 5 days. The biopsy specimen revealed necrotizing eosinophilic myocarditis. Left ventricular function recovered within a week without corticosteroid therapy. No relapse was observed as of 8 months after diagnosis.

15 keywords...

hide…