ArticleJACC. Case reports2025
An Unusual Case of Pulmonary Embolism Leading to the Diagnosis of Eosinophilic Granulomatosis With Polyangiitis.
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 systemic vasculitis that can present with eosinophilic myocarditis (EM). We present a rare presentation of EGPA with right ventricle (RV) thrombus and pulmonary embolism (PE). CASE SUMMARY: A 36-year-old male presented with chest pain and elevated troponin. The echocardiogram showed normal left ventricular size and global systolic function but a moderately dilated RV with mildly reduced systolic function. The cardiac tomography angiography of the chest identified a PE and raised suspicion for RV enlargement and possible thrombus. Cardiac magnetic resonance imaging revealed diffuse subendocardial late gadolinium enhancement and wall thickening in the RV raising concern for EM. He was started on anticoagulation, corticosteroids, and immunosuppressants with complete resolution noted in repeat magnetic resonance imaging in 9 months. DISCUSSION: RV thrombus with PE in EGPA-associated EM is rare, with few cases reported. TAKE-HOME MESSAGE: Early recognition with advanced imaging and timely intervention can prevent fatal complications in patients with EM.
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