The posterior leaflet of the mitral valve apparatus was completely embedded in a big organized. Background loeffler endocarditis and endomyocardial fibrosis are restrictive cardiomyopathies, defined as diseases of the heart muscle that result in impaired ventricular filling with normal or decreased diastolic volume of either or both ventricles. The parasite can be strongyloides stercoralis, dirofilaria immitis or ascaris which can enter the body through contact with the soil. Complete resolution with corticosteroids sen t, ponde ck, udwadia zf abstract hypereosinophilic syndrome hes is classically defined as prolonged, unexplained peripheral eosinophilia in a patient presenting with evidence of endorgan damage. An 81yearold woman presenting with confusion and drowsiness was admitted to the intensive care unit. Loeffler endocarditis as a rare cause of heart failure. Echocardiography was essential for structural abnormalities. Loeffler endocarditis is a complication of hypereosinophilic syndrome resulting from eosinophilic infiltration of heart tissue. Loeffler endocarditis is a rare restrictive cardiomyopathy caused by abnormal endomyocardial infiltration of eosinophils, with subsequent tissue. These germs come through your bloodstream from another part of your body, often your mouth. Endocarditis, also called infective endocarditis ie, is an inflammation of the inner lining of the heart. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis.
We report the case of a young woman with pleuritic chest pain associated with fever and hypereosinophilia. First described in 1936, loefflers endocarditis is the cardiological. Loefflers endocarditis presenting as mitral and tricuspid stenosis. Systolic function and wall thickness may remain normal, especially early in the disease, as reported by. Loeffler endocarditis is a rare diagnosis characterized by unique imaging findings as demonstrated by this case. Systolic function and wall thickness may remain normal, especially early in the disease, as reported by richardson and associates. Loeffler endocarditis is now regarded as a manifestation of eosinophilic myocarditis, a disorder that involves the infiltration of heart tissue by bloodborn eosinophils that leads to three progressive clinical stages. Charles martin loeffler 18611935, germanborn american composer. In the present study, we report a case of a 60yearold man diagnosed with leftsided restrictive cardiomyopathy with a preserved ejection fraction, which was identified as loeffler endocarditis.
Hardy diagnostics loeffler medium is a modification of the original formula developed by loeffler in 1887. The most common type, bacterial endocarditis, occurs when germs enter your heart. Cardiac involvement may be present in 50 to 60% of the patients. Restrictive cardiomyopathy is a disease of the heart muscle which results in impaired filling of the heart ventricles, i. Loefflers endocarditis caused by strongyloides infection. Laboratory analysis showed a leucocytosis of 23 000.
Endocarditis infective endocarditis ie medlineplus. Loeffler endocarditis is a form of heart disease characterized by a stiffened, poorlyfunctioning. Loefflers endocarditis is generally caused by hypereosinophilic syndrome. Loeffler endocarditis prof ariyanto harsono md phd spak 2. Loeffler endocarditis was first reported by, wilhelm loeffler, a swiss clinician scientist, in 1936. The presence of infective endocarditis and simultaneous loefflers endocarditis has been reported once before by menz et al. Loefflers endocarditis, a rare cardiac manifestation of hypereosinophilic syndrome hes, is characterized by fibrous thickening of the endocardium of both ventricles, leading to apical. Pharmacological therapy was initiated with diuretics, high dose betablockers, methylprednisolone mg a day for three days and anticoagulation along with antiplatelet agents acetylsalicylic acid and clopidogrel.
Loeffler endocarditis and endomyocardial fibrosis are restrictive cardiomyopathies, defined as diseases of the heart muscle that result in impaired ventricular filling with normal or decreased diastolic volume of either or both ventricles. Loefflers endocarditis characteristically produces cardiac dysfunction by the combined effects of endocardial fibrosis with restriction to diastolic inflow and intracavitary thrombosis with partial cavity obiliteration. In most cases it is traced back to people producing or trading spoons german. Recurrent infective endocarditis as a manifestation of. Hypereosinophilic syndrome with isolated loefflers endocarditis. She was hospitalized with suspected acute myopericarditis and. Loeffler endocarditis is a form of restrictive cardiomyopathy caused by infiltration of the heart by white blood cells known as eosinophils.
Loeffler endocarditis wikipedia republished wiki 2. Mechanical ventilation was necessary for twelve days. Loefflers endocarditis is an acute form of primary restrictive cardiomyopathy. At the echocardiography, there was a huge mass in the left ventricular cavity, resulting in inflow and outflow tract obstruction.
Bacterial endocarditis can damage your heart valves. This case emphasizes the role of cmr as a diagnostic modality for loefflers endocarditis. Davies disease or endomyocardial fibrosis occurs from any disorder that elevates the eosinophil count such as parasitic infections. It is a restrictive cardiomyopathy characterized with eosinophilia. Michael arustamyan, do, jamael hoosain, md, jennifer mattson, md, syed farhan. Infiltration of the myocardium by eosinophilic cells following endomyocardial fibrosis is known as loeffler endocarditis. Loeffler s endocarditis is a clinical condition characterized by combination of three key findings. A case of loefflers endocarditis associated with churgstrauss. Hypereosinophilic syndrome with isolated loefflers. Hypereosinophilic syndrome hes is a rare disorder with unknown global prevalence, barely reported in hispanic population, and characterized by persistent eosinophilia in association with organ dysfunctions directly attributable to eosinophilic infiltration. Loeffler endocarditis refers to an inflammation of the endocardium that may be observed in patients suffering from idiopathic hypereosinophilic syndrome.
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