Cardiac Magnetic Resonance Imaging (MRI) in a Woman With Acute Coronary Syndrome Symptoms and Eosinophilia

A woman in her 50s with discoid lupus in remission and recent adult-onset asthma was diagnosed as having eosinophilic myopericarditis associated with eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome) on the basis of acute coronary syndrome symptoms (dyspnea on exertion, substernal chest pain radiating to her jaw), marked peripheral eosinophilia, elevated troponin and C-reactive protein levels, and eosinophilic infiltration of her myocardium on biopsy. Cardiac magnetic resonance imaging demonstrated foci of delayed mid-myocardial gadolinium enhancement, diffuse pericardial thickening, severe biventricular systolic dysfunction, and a small pericardial effusion. She was treated successfully with corticosteroids and mepolizumab. Click the Related Article link for complete case details.