Utility of cardiac magnetic resonance imaging in diagnosing eosinophilic myocarditis in a patient recently recovered from COVID-19: a grand round case report

Karan Rao; Michael Arustamyan; Abby Walling; Georgios Christodoulidis; Mahi Ashwath; Joshua Hagedorn; Sarv Priya

doi:10.1093/ehjcr/ytad090

Back

Utility of cardiac magnetic resonance imaging in diagnosing eosinophilic myocarditis in a patient recently recovered from COVID-19: a grand round case report

Journal article

Open access

Peer reviewed

Utility of cardiac magnetic resonance imaging in diagnosing eosinophilic myocarditis in a patient recently recovered from COVID-19: a grand round case report

Karan Rao, Michael Arustamyan, Abby Walling, Georgios Christodoulidis, Mahi Ashwath, Joshua Hagedorn and Sarv Priya

European heart journal : case reports, Vol.7(3), ytad090

02/18/2023

DOI: 10.1093/ehjcr/ytad090

PMCID: PMC10053638

PMID: 37006798

Files and links (1)

url

https://doi.org/10.1093/ehjcr/ytad090View

Published (Version of record) Open Access

Abstract

Background: Eosinophilic myocarditis (EM) secondary to eosinophilic granulomatosis with polyangiitis (EGPA) is a rare disease, for which cardiac magnetic resonance imaging (CMRI) is a useful non-invasive modality for diagnosis. We present a case of EM in a patient who recently recovered from COVID-19 and discuss the role of CMRI and endomyocardial biopsy (EMB) to differentiate between COVID-19-associated myocarditis and EM. Case summary: A 20-year-old Hispanic male with a history of sinusitis and asthma, and who recently recovered from COVID-19, presented to the emergency room with pleuritic chest pain, dyspnoea on exertion, and cough. His presentation labs were pertinent for leucocytosis, eosinophilia, elevated troponin, and elevated erythrocyte sedimentation rate and C-reactive protein. The electrocardiogram showed sinus tachycardia. Echocardiogram showed an ejection fraction of 40%. The patient was admitted, and on day 2 of admission, he underwent CMRI which showed findings of EM and mural thrombi. On hospital day 3, the patient underwent right heart catheterization and EMB which confirmed EM. The patient was treated with steroids and mepolizumab. He was discharged on hospital day 7 and continued outpatient heart failure treatment. Discussion: This is a unique case of EM and heart failure with reduced ejection fraction as a presentation of EGPA, in a patient who recently recovered from COVID-19. In this case, CMRI and EMB were critical to identify the cause of myocarditis and helped in the optimal management of this patient.

AcademicSubjects

Cardiac magnetic resonance imaging

Case report

COVID-associated myocarditis

Ehjcr

Eosinophilic myocarditis

Grand Round

MED00200

Vasculitis

Details

Title: Subtitle: Utility of cardiac magnetic resonance imaging in diagnosing eosinophilic myocarditis in a patient recently recovered from COVID-19: a grand round case report
Creators: Karan Rao - University of Iowa
Michael Arustamyan - University of Iowa Hospitals and Clinics
Abby Walling - University of Iowa
Georgios Christodoulidis - University of Iowa
Mahi Ashwath - University of Iowa
Joshua Hagedorn - University of Iowa
Sarv Priya - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: European heart journal : case reports, Vol.7(3), ytad090
DOI: 10.1093/ehjcr/ytad090
PMID: 37006798
PMCID: PMC10053638
NLM abbreviation: Eur Heart J Case Rep
eISSN: 2514-2119
Publisher: Oxford University Press
Language: English
Date published: 02/18/2023
Academic Unit: Radiology; Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984381134402771

Metrics

6 Record Views

3 Times Cited - Web of Science

See more details