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  • Hypereosinophilic syndrome: a rare cause of ST-elevation myocardial infarction and thrombus formation on the aortic valve

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Cardiology
Hypereosinophilic syndrome: a rare cause of ST-elevation myocardial infarction and thrombus formation on the aortic valve
  1. Mathias Dyreborg Jørgensen1,
  2. Ida Ransby Schneider1,
  3. Gunhild Nynke Thomsen2 and
  4. Jordi Sanchez Dahl1
  1. 1 Department of Cardiology, Odense Universitetshospital, Odense, Denmark
  2. 2 Department of Hematology, Odense Universitetshospital, Odense, Denmark
  1. Correspondence to Mathias Dyreborg Jørgensen; mathias.dyreborg.jorgensen{at}rsyd.dk

Abstract

We present a case of a man in his 30s presenting with ST-segment elevation myocardial infarction and eosinophilia. The patient underwent thrombus aspiration and initially echocardiographic evaluation was normal. The patient was discharged after 2 days, but was hospitalised again after 6 days. Echocardiographic evaluation now revealed a thrombus formation on the aortic valve. Laboratory data revealed increasing eosinophilia, and treatment with high-dosage corticosteroids and hydroxyurea was initiated as eosinophilic disease with organ manifestations could not be precluded. Eosinophils normalised and the patient was discharged again. The combination of hypereosinophilia and absence of infection, rheumatological disorders and malignancy, led to reactive or idiopathic hypereosinophilic syndrome being the most plausible diagnoses. The patient was closely monitored in the cardiology and haematology outpatient clinics. Echocardiographic evaluation, performed 6 weeks after the patient was discharged, showed significant regression in the size of the thrombus mass.

  • Valvar diseases
  • Cardiovascular medicine
  • Haematology (incl blood transfusion)

https://doi.org/10.1136/bcr-2023-259494

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    Footnotes

    • Contributors MDJ, IRS, GNT, JSD were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. MDJ, IRS, GNT, JSD gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.