CASE REPORT

Heart and Vessels

, Volume 18, Issue 1, pp 43-46

Löffler's endocarditis associated with unusual ECG change mimicking posterior myocardial infarction

  • Hidetomo MaruyoshiAffiliated withDepartment of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. myamagi@hsp.ncvc.go.jp
  • , Satoshi NakataniAffiliated withDepartment of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. myamagi@hsp.ncvc.go.jp
  • , Yoshio YasumuraAffiliated withDepartment of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. myamagi@hsp.ncvc.go.jp
  • , Akihisa HanataniAffiliated withDepartment of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. myamagi@hsp.ncvc.go.jp
  • , Tomoyoshi YamaguchiAffiliated withDepartment of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. myamagi@hsp.ncvc.go.jp
  • , Chikao YutaniAffiliated withDivision of Pathology, National Cardiovascular Center, Osaka, Japan
  • , Hatsue Ishibashi-UedaAffiliated withDivision of Pathology, National Cardiovascular Center, Osaka, Japan
  • , Kunio MiyatakeAffiliated withDepartment of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. myamagi@hsp.ncvc.go.jp
  • , M. YamagishiAffiliated withDepartment of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. myamagi@hsp.ncvc.go.jp

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Abstract.

 A 73-year-old man with a history of bronchial asthma and atrial fibrillation was admitted to our hospital because of dyspnea and back pain. Blood analysis revealed a marked increase in total blood cell and eosinophil counts. The creatine kinase and creatine kinase-MB increased slightly. The ECG demonstrated significant ST-segment depression that mimicked acute posterior myocardial infarction. Emergent coronary angiography showed no stenotic lesions. The histological findings in endomyocardial biopsy showed thickened endocardium associated with significant eosinophilic infiltration, which was compatible with Löffler's endocarditis. After the administration of prednisolone, the patient's general condition, eosinophilia, ECG abnormalities, and histological findings were improved dramatically. The endomyocardial biopsy in the acute phase was helpful for diagnosis and therapeutic decision-making.

Key words Löffler's endocarditis Eosinophilia ST segment depression Biopsy