Right sided heart failure secondary to hypereosinophilic cardiomyopathy – clinical manifestation and diagnostic pathway

• Main Authors: Jennie Han, BA, BM BCh, Mohammad Ramtoola, MB ChB, Muhammad Shahzad, MBBS, Kenneth Okonkwo, MBBS, Nadeem Attar, MBBS
• Format: Article
• Language: English
• Published: Elsevier 2020-10-01
• Series: Radiology Case Reports
• Subjects: Hypereosinophillic cardiomyopathy; Restrictive cardiomyopathy; Hypereosinophillic syndrome; Loeffler endocarditis; Cardiac magnetic resonance imaging; Heart failure
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320304015

Hypereosinophilic cardiomyopathy is a rare restrictive cardiomyopathy which often presents with left-sided heart failure. We present an interesting case of a 58-year-old male patient with known hypereosinophillic syndrome who had presented with congestive cardiac failure with predominant features of right-sided volume overload. Cardiac magnetic resonance imaging confirmed the diagnosis by demonstrating obliteration of the right ventricular apex and endocardial-delayed gadolinium enhancement at the mid-septal and inferior segment, at both the right ventricular and left ventricular apical region, consistent with fibrosis. He was successfully treated with intravenous diuretics to good effect.This case report demonstrates a rare clinical presentation of right ventricle involvement in hypereosinophilic cardiomyopathy and the current pathway for diagnosis with the favoured emergence of cardiac magnetic resonance imaging. All patients with hypereosinophilic syndrome should be closely monitored for signs of cardiac involvement, as early treatment carries a better prognosis.