Echocardiographic monitoring of myocardial function in a female patient with right heart Loeffler endocarditis at thrombotic stage after Epstein-Barr-virus infection

Int J Cardiovasc Imaging. 2024 Sep;40(9):2007-2013. doi: 10.1007/s10554-024-03147-2. Epub 2024 May 23.

Abstract

Background: Transthoracic echocardiography is usually the first non-invasive imaging modality for the detection of Loeffler endocarditis at thrombotic stage. In the recent decade 3D echocardiography and deformation imaging already proved as a helpful tool for the monitoring of left and right ventricular heart disease.

Case presentation: The present case illustrates the diagnostic role of 3D echocardiography and deformation imaging in the acute stage of right sided Loeffler endocarditis in a 70-year-old Western European (German) woman. This case proves that myocardial involvement due to inflammation can be detected at subclinical stages by speckle tracking echocardiography. Acute deterioration of left and right ventricular function and the early response to prednisolone therapy can objectively be monitored. In addition, alterations of effective stroke volume can quantitatively be assessed by 3D right ventricular volumetry with exclusion of thrombus formation in the volume measurements.

Conclusion: This case underlines the importance of 3D echocardiography and deformation imaging as a helpful diagnostic tool in disease management in the acute phase of Loeffler endocarditis at thrombotic stage.

Keywords: 3D echocardiography; Deformation imaging; Disease monitoring; Speckle tracking; Thrombotic loeffler endocarditis.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aged
  • Echocardiography, Three-Dimensional*
  • Endocarditis / complications
  • Endocarditis / diagnostic imaging
  • Endocarditis / drug therapy
  • Endocarditis / physiopathology
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / diagnostic imaging
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Hypereosinophilic Syndrome* / complications
  • Hypereosinophilic Syndrome* / diagnostic imaging
  • Hypereosinophilic Syndrome* / drug therapy
  • Hypereosinophilic Syndrome* / physiopathology
  • Predictive Value of Tests*
  • Prednisolone / therapeutic use
  • Stroke Volume
  • Thrombosis* / diagnostic imaging
  • Thrombosis* / drug therapy
  • Thrombosis* / physiopathology
  • Treatment Outcome
  • Ventricular Dysfunction, Right / diagnostic imaging
  • Ventricular Dysfunction, Right / drug therapy
  • Ventricular Dysfunction, Right / etiology
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Left*
  • Ventricular Function, Right*

Substances

  • Prednisolone
  • Glucocorticoids