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(Circulation. 2002;105:3066.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Eosinophilic Pericarditis and Myocarditis

Qiang Li, MD, DSc; Deepali Gupta, MD; George Schroth, MD; Catalin Loghin, MD; George V. Letsou, MD; L. Maximilian Buja, MD

From Department of Medicine/Division of Cardiology (Q.L., G.S., C.L.), Department of Cardiothoracic and Vascular Surgery (G.V.L.), and Department of Pathology and Laboratory Medicine (D.G., L.M.B.), the University of Texas Health Science Center at Houston.

Correspondence to L. Maximilian Buja, MD, Dean, The University of Texas Medical School at Houston, 6431 Fannin, MSB 2.026, Houston, TX 77030. E-mail L.Maximilian.Buja{at}uth.tmc.edu

A 58-year-old African-American woman with long-standing asthma presented with a 1 month history of severe dyspnea on exertion, orthopnea, and weight loss. One week before hospitalization, she could only sleep sitting in a chair. She was found to have 50% eosinophils on peripheral blood smear without bone marrow malignancy. Cardiac enzymes were elevated. Electrocardiography revealed low-voltage QRS complexes without ST or T wave changes. Chest radiograph showed bilateral pleural effusions. Echocar- diography documented a restrictive filling pattern with nor-mal systolic function and a pericardial effusion. A pericardial window was performed through a left anterior thoracotomy, and 400 mL of bloody pericardial fluid was withdrawn. Pericardial biopsy (Figure 1) and myocardial biopsy (Figure 2) confirmed the diagnosis of eosinophilic pericarditis and eosinophilic myocarditis. These are features of Loeffler’s fibroplastic parietal endocarditis, which can lead to endomyocardial fibrosis and restrictive cardiomyopathy.

View larger version (134K): [in this window] [in a new window]   Figure 1. Pericardium: eosinophilic infiltrates and chronic inflammation (HE x200).

View larger version (139K): [in this window] [in a new window]   Figure 2. Myocardium: myocardial eosinophilic infiltrates with fibrosis and myocyte degeneration (HE x200).

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Li, Q. Articles by Buja, L. M. Search for Related Content PubMed PubMed Citation Articles by Li, Q. Articles by Buja, L. M. Related Collections Pericardial disease Myocardial cardiomyopathy disease Other diagnostic testing CV surgery: other