scholarly journals The Underrecognized Cardiac Manifestation of Hypereosinophilic Syndrome

2018 ◽  
Vol 1 (1) ◽  
pp. 01-03
Author(s):  
Ashwin Malhotra

Hypereosinophilic syndrome (HES) is a rare systemic disease in which cardiac manifestations are the leading cause of morbidity and mortality. HES involvement of the heart can often clinically mimic acute coronary syndrome (ACS) with the patient undergoing repeat cardiac catheterizations when no conclusive diagnosis is arrived at, and no effective treatment is suggested to alleviate recurrent symptoms of chest discomfort. Here we present an elusive case of eosinophilic myocarditis (EM) and advocate that a detailed review of history as well as obtaining all medical records be done to avoid unnecessary and repeated invasive investigations in order to provide safe, cost effective, and efficient care for our patients.

2021 ◽  
pp. 1-3
Author(s):  
Tahmineh Tahouri ◽  
Mohammad Mahdavi ◽  
Kiara Rezaei-Kalantari ◽  
Hossein Shahzadi

Abstract Hypereosinophilic syndrome is defined as persistent eosinophilia in the blood for more than 6 months, without any identifiable cause and with end-organ involvement evidence. Cardiac manifestations of HES include heart failure due to restrictive cardiomyopathy, arrhythmia, intraventricular thrombosis, and coronary artery involvement occurs frequently. In rare instances, coronary ectasia, aneurysms, or dissection can occur and cause morbidity and mortality in these patients. A coronary aneurysm occurs rarely in adult patients with HES but to our knowledge, this is the first report of this association in a 14-year-old boy who was presented to us as coronary aneurysm due to hypereosinophilic syndrome.


2021 ◽  
Vol 8 (12) ◽  
pp. 1852
Author(s):  
Parshv P. Shah ◽  
Harvy Parikh ◽  
Hemant Shah ◽  
Nilesh Doctor

Background: Hypothyroidism is the most common pathological hormone deficiency. To study various cardiac manifestations in overt and subclinical hypothyroidism.Methods: The cross-sectional analytic study is carried out on 60 patients of hypothyroid subjects in indoor facility of general medicine department in SMIMER hospital.Results: This study shows positive correlation between thyroid stimulating hormone (TSH) level, electrocardiogram (ECG) and echocardiographic findings. In this study, there is female predominance, ECG findings most commonly suggestive of sinus bradycardia and ECHO findings are most commonly suggestive of diastolic dysfunction with pericardial effusion.Conclusions: The early recognition and early initiation of treatment of hypothyroidism may helpful to lowering heart changes as hypothyroidism is reversible cause for cardiac manifestation.


2021 ◽  
Vol 11 (1) ◽  
pp. 31239.1-31239.10
Author(s):  
Farzad Gheshlaghi ◽  
◽  
Anselm Wong ◽  
Gholamali Dorooshi ◽  
Rokhsareh Meamar ◽  
...  

Background: Digoxin is extensively prescribed for cardiac diseases, so its chronic or acute toxicity commonly occur. Although digoxin specific antibodies (anti-digoxin Fab) are recommended to be used in patients with cardiac symptoms of digoxin toxicity, there is ongoing controversy about the effectiveness and dose of anti-digoxin Fab. Because our department lacks access to anti-digoxin Fab and the high cost of the antidote, we evaluated 10 years of experience in treating patients with digoxin toxicity without using digoxin Fab antibodies considering outcomes. Methods: A retrospective study was performed in Khorshid Hospital, affiliated with Isfahan University of Medical Sciences, from October 2008 to September 2018. Patients with acute or chronic digoxin toxicity were included in the study. The patients’ data were gathered and analyzed according to their medical documents. Results: Out of 150 cases with digoxin toxicity, 38% (n=57) were acute and 62% (n=93) were chronic. About 64.7% (n=97) were female. The most common non-cardiac manifestations of toxicity were gastrointestinal (67.3%, n=101) and neurological symptoms (52.7%, n=79). Bradyarrhythmia (80.5%, n=33) was the most cardiac manifestation in patients with acute (15.8% n=9) and chronic (25.8%, n=24) toxicity. A total of 144 (96%) cases fully recovered with supportive care, and 6 patients (4%) died. None of the cases received anti-digoxin Fab. Conclusion: The majority of presentations with acute or chronic toxicity recovered with supportive measures without using anti-digoxin Fab.


2020 ◽  
Author(s):  
Fan-xin Kong ◽  
Meng Li ◽  
Chun-Yan Ma ◽  
Ping-ping Meng ◽  
Yong-huai Wang ◽  
...  

Abstract Background Loeffler’s endocarditis is an inflammatory cardiac condition of hypereosinophilic syndrome which rarely involves coronary artery. When coronary artery is involved, known as eosinophilic coronary periarteritis, the clinical presentation, electrocardiographic changes and troponin level are extremely nonspecific and may mimic acute coronary syndrome. It is very important to make differential diagnosis for ECPA in order to avoid the unnecessary further invasive coronary angiography. Case presentation We report a case with chest pain, ST-segment depression in electrocardiogram and increased troponin-I mimicking acute non-ST-segment elevation myocardial infarction. However, quick echocardiography showed endomyocardial thickening with normal regional wall motion, which corresponded to the characteristics of Loeffler’s endocarditis. Emergent blood analysis showed marked increase in eosinophils and computed tomography angiography found no significant stenosis of coronary artery. Manifestations of magnetic resonance imaging consisted with findings of echocardiography. Finally, the patient was diagnosed as Loeffler’s endocarditis and possible coronary spasm secondary to eosinophilic coronary periarteritis. Conclusion This case exhibits the crucial use of quick transthoracic echocardiography and the emergent hematological examination for differential diagnosis in such scenarios as often if electrocardiogram change mimicking myocardial infarction.


2020 ◽  
Vol 21 (9) ◽  
pp. 1317-1327 ◽  
Author(s):  
Laura Pirhonen ◽  
Hanna Gyllensten ◽  
Andreas Fors ◽  
Kristian Bolin

Abstract Background Person-centred care has been shown to be cost-effective compared to usual care for several diseases, including acute coronary syndrome, in a short-term time perspective (< 2 years). The cost-effectiveness of person-centred care in a longer time perspective is largely unknown. Objectives To estimate the mid-term cost-effectiveness of person-centred care compared to usual care for patients (< 65) with acute coronary syndrome, using a 2-year and a 5-year time perspective. Methods The mid-term cost-effectiveness of person-centred care compared to usual care was estimated by projecting the outcomes observed in a randomized-controlled trial together with data from health registers and data from the scientific literature, 3 years beyond the 2-year follow-up, using the developed simulation model. Probabilistic sensitivity analyses were performed using Monte Carlo simulation. Results Person-centred care entails lower costs and improved effectiveness as compared to usual care, for a 2-year time and a 5-year perspective. Monte Carlo simulations suggest that the likelihoods of the person-centred care being cost-effective compared to usual care were between 80 and 99% and between 75 and 90% for a 2-year and a 5-year time perspective (using a 500,000 SEK/QALY willingness-to-pay threshold). Conclusions Person-centred care was less costly and more effective compared to usual care in a 2-year and a 5-year time perspective for patients with acute coronary syndrome under the age of 65.


2019 ◽  
Vol 73 (9) ◽  
pp. 2186
Author(s):  
Junya Komatsu ◽  
Ayaka Machida ◽  
Hikaru Imafuku ◽  
Ryota Kida ◽  
Yoshihiro Ohkawa ◽  
...  

Author(s):  
Clothilde Berger ◽  
Sara Boccalini ◽  
Anne Champagnac ◽  
Michel Ovize ◽  
Thomas Bochaton

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