ArticleJACC. Case reports2025
Endomyocarditis in Eosinophilic Granulomatosis With Polyangiitis: Cardiac Magnetic Resonance Imaging Highlights Treatment Success.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis; cardiac involvement is common and worsens prognosis. CASE SUMMARY: A 42-year-old man presented with chest pain, marked ST-T changes, eosinophilia, and elevated troponin, without obstructive coronary disease. He was diagnosed with acute eosinophilic endomyocarditis, mildly reduced left ventricular (LV) ejection fraction, and a large apical thrombus-an initial manifestation of probable EGPA. The patient received anticoagulation, corticosteroids, and immunosuppressive therapy. Endomyocardial fibrosis was confirmed via LV biopsy. During follow-up, electrocardiography and troponin T normalized, cardiac magnetic resonance (CMR) showed thrombus resolution, LV function recovery, and persistent subendocardial fibrosis. DISCUSSION: This case illustrates severe cardiac involvement in EGPA, with serial cardiac testing including striking electrocardiogram and CMR findings. TAKE-HOME MESSAGE: Cardiac involvement in EGPA is prevalent. Complete cardiac screening including CMR is advisable in all patients.
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