Cardiac magnetic resonance imaging of eosinophilic endomyocardial disease

Int J Cardiol. 2008 Jun 6;126(3):e50-2. doi: 10.1016/j.ijcard.2007.01.019. Epub 2007 Mar 30.

Abstract

Idiopathic hypereosinophilic syndrome (HES) is rare and frequently involves the heart with development of endomyocardial fibrosis, a characteristic restrictive cardiomyopathy. Non-invasive diagnosis is frequently challenging. Recent developments in cardiac magnetic resonance (CMR) imaging techniques offer potential for improved detection and characterization of this entity. We describe the use of contrast-enhanced CMR to demonstrate thrombus, endomyocardial fibrosis and inflammation in eosinophilic endomyocardial disease. A three-layered appearance consisting of normal myocardium, thickened fibrotic endocardium with inflammatory exudate, and overlying thrombus was seen on cine-images. Post-contrast perfusion and delayed enhancement images confirmed the presence and location of endomyocardial fibrosis and thrombus. CMR is an important and powerful addition to current non-invasive diagnostic tools for the clinical diagnosis of eosinophilic endomyocardial disease, and may potentially obviate the need for cardiac biopsy in the future.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Contrast Media / pharmacology
  • Drug Therapy, Combination
  • Echocardiography, Transesophageal
  • Endomyocardial Fibrosis / complications
  • Endomyocardial Fibrosis / diagnosis*
  • Endomyocardial Fibrosis / drug therapy
  • Female
  • Follow-Up Studies
  • Gadolinium DTPA
  • Heart Failure / diagnosis
  • Heart Failure / etiology
  • Humans
  • Hypereosinophilic Syndrome / complications
  • Hypereosinophilic Syndrome / diagnosis*
  • Hypereosinophilic Syndrome / drug therapy
  • Image Enhancement / methods
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Risk Assessment
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Gadolinium DTPA