EOSINOPHILIC MYOCARDITIS MANIFESTING AS MYOCARDIAL-INFARCTION - EARLYDIAGNOSIS AND SUCCESSFUL TREATMENT

Objective: To report a case of eosinophilic myocarditis with remarkabl e initial clinical manifestations and outcome. Material and Methods: A 67-year-old woman with hypertension and a history of asthma and drug hypersensitivity was referred to our institution with a diagnosis of a cute myocardial infarction on the basis of severe chest pain, ST eleva tion on an electrocardiogram, and a slight increase in cardiac enzymes , Further diagnostic studies were performed. Results: Echocardiography disclosed left ventricular dysfunction in conjunction with apical asy nergy, thinning, and thrombus, The eosinophil count in the peripheral blood was increased only slightly, Coronary angiography showed normal arteries and prompted the performance of endomyocardial biopsy, which revealed active eosinophilic myocarditis. After corticosteroid therapy , global and regional left ventricular function returned to normal. Co nclusion: This unusual clinical picture and outcome demonstrate that e osinophilic myocarditis may simulate acute myocardial infarction and s hould be considered in patients with a history of allergies or acute l eft ventricular dysfunction, even in the absence of pronounced eosinop hilia in the peripheral blood, With appropriate medical therapy, recov ery for these patients can be complete.