Document Detail

Therapeutic role of pericardiocentesis for acute necrotizing eosinophilic myocarditis with cardiac tamponade.
MedLine Citation:
PMID:  12839087     Owner:  NLM     Status:  MEDLINE    
We describe a patient with acute necrotizing eosinophilic myocarditis who recovered rapidly after pericardial drainage and without corticosteroid therapy. The 25-year- old man was referred to our hospital with suspected acute myocardial infarction on the basis of severe epigastralgia, abnormal Q waves and ST elevation on electrocardiography, and an increase in cardiac enzymes. Echocardiography disclosed pericardial effusion that compressed the right ventricle, left ventricular dysfunction in conjunction with posterolateral hypokinesis, and a thickened ventricular wall but no mural thrombus. The eosinophil count in the peripheral blood was slightly increased. Coronary angiography showed normal arteries and thus prompted an endomyocardial biopsy. The patient was transferred to the intensive care unit with a clinical diagnosis of myocarditis associated with cardiac tamponade. Emergency pericardiocentesis relieved symptoms immediately. The cells in the pericardial effusion were mainly eosinophils; interleukin 5 and interleukin 13 levels were predominantly elevated, and the effusion was drained for 5 days. The biopsy specimen revealed necrotizing eosinophilic myocarditis. Left ventricular function recovered within a week without corticosteroid therapy. No relapse was observed as of 8 months after diagnosis.
Ryu Kazama; Yuji Okura; Makoto Hoyano; Ken Toba; Yukie Ochiai; Noriko Ishihara; Takashi Kuroha; Tsuyoshi Yoshida; Osamu Namura; Masakazu Sogawa; Yuichi Nakamura; Nobuhiko Yoshimura; Ken Nishikura; Kiminori Kato; Haruo Hanawa; Yusuke Tamura; Shinichiro Morimoto; Makoto Kodama; Yoshifusa Aizawa
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  78     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-03     Completed Date:  2003-07-22     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  901-7     Citation Subset:  AIM; IM    
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MeSH Terms
Cardiac Tamponade / complications,  etiology*
Eosinophilia / complications*,  pathology
Myocarditis / complications,  physiopathology,  surgery*
Treatment Outcome

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