Case Report: An Unusual Presentation of Cardiovascular Involvement in Eosinophilic Granulomatosis With Polyangiitis

Frontiers in Cardiovascular Medicine

article

Yajuan Li¹  Hui Zhou¹  Yaou Zhou³  Haixiong Tang¹ 

[1] Department of Radiology, Xiangya Hospital Central South University;National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University;Department of Rheumatology and Immunology, Xiangya Hospital Central South University;Department of Radiology, The Fourth People's Hospital of Chenzhou

关键词: eosinophilic granulomatosis with polyangiitis;    Löffler endocarditis;    thrombosis;    pulmonary hypertension;    right-sided heart failure;    cardiac magnetic resonance imaging;   

DOI  :  10.3389/fcvm.2022.928192

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background Because eosinophilic granulomatosis with polyangiitis (EGPA) is so rare and the symptoms so varied, it can be a challenge to get a correct diagnosis in clinical practice. Cardiovascular involvement is the main cause of death of EGPA. We are the first to report of cardiac magnetic resonance (CMR) findings about right-sided heart involvement in EGPA. Patient Findings The initial abnormalities detected by CMR were Löffler endocarditis with extensive thrombosis and left ventricular (LV) dysfunction. After active treatment, LV systolic function recovered and endocarditis with thrombosis significantly improved, but there was rapidly progressive pulmonary hypertension, enlargement of right atrium and right ventricle and persistent right-sided heart failure. The patient eventually died of sudden cardiac death 6 months after hospital discharge. Conclusions Löffler endocarditis and right-sided heart involvement are both rare presentations in patients with EGPA. CMR is a reliable non-invasive tool to precisely and comprehensively assess cardiovascular involvement in EGPA.

【 授权许可】

CC BY