Forensic Science, Medicine, and Pathology

, Volume 13, Issue 2, pp 255–258 | Cite as

Necrotizing eosinophilic myocarditis

  • Martin JaníkEmail author
  • Petr Hejna
Images in Forensics

A 23-year-old woman with a history of remote diffuse axonal injury-associated traumatic brain injury developed sudden circulatory collapse requiring prolonged pre-hospital cardiopulmonary resuscitation, vasopressors, and intubation. Her recent medical history included depression, mild psycho-organic syndrome, chronic musculoskeletal pain, nonsteroidal anti-inflammatory drug abuse, nootropic therapy, and smoking. There were no known tendencies of allergy. Shortly after her admission to an intensive care unit, the patient was noted to be hemodynamically unstable with a critical score of Glasgow Coma Scale (GCS 4). The electrocardiogram showed marked ST-segment elevation in all leads. Echocardiography showed mild concentric left ventricle hypertrophy, global hypokinesis, and severe left ventricular dysfunction. The right ventricle was mildly dilated and hypokinetic. The laboratory evaluation was remarkable for elevated levels of cardiac troponins and C-reactive protein. The white blood...



The authors would like to express their sincere thanks to Professor Ivo Šteiner for his valuable comments and insightful suggestions on this paper.

Compliance with ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Löffler W. Endocarditis parietalis fibroplastica with eosinophilia. A strange disease. Schweizerische Medizinische Wochenschrift. 1936;18:817–20.Google Scholar
  2. 2.
    Huston B, Froloff V, Mills K, McGee M. Death due to eosinophilic necrotizing myocarditis despite steroid treatment. Am J Forensic Med Pathol. 2013;34:95–7.CrossRefGoogle Scholar
  3. 3.
    Chikwava KR, Savell Jr VH, Boyd TK. Fatal cephalosporin-induced acute hypersensitivity myocarditis. Pediatr Cardiol. 2006;27:777–80.CrossRefGoogle Scholar
  4. 4.
    Al Ali AM, Straatman LP, Allard MF, Ignaszewski AP. Eosinophilic myocarditis: case series and review of literature. Can J Cardiol. 2006;22:1233–7.CrossRefGoogle Scholar
  5. 5.
    Séguéla PE, Iriart X, Acar P, Montaudon M, Roudaut R, Thambo JB. Eosinophilic cardiac disease: molecular, clinical and imaging aspects. Arch Cardiovasc Dis. 2015;108:258–68.CrossRefGoogle Scholar
  6. 6.
    Kitulwatte ID, Kim PJ, Pollanen MS. Sudden death related myocarditis: a study of 56 cases. Forensic Sci Med Pathol. 2010;6:13–9.CrossRefGoogle Scholar
  7. 7.
    Byard RW. Forensic pathology and problems in determining cause of death. Forensic Sci Med Pathol. 2008;4:73–4.CrossRefGoogle Scholar
  8. 8.
    Cooper LT, Zehr KJ. Biventricular assist device placement and immunosuppression as therapy for necrotizing eosinophilic myocarditis. Nat Clin Pract Cardiovasc Med. 2005;2:544–8.CrossRefGoogle Scholar
  9. 9.
    Galiuto L, Enriquez-Sarano M, Reeder GS, Tazelaar HD, Li JT, Miller Jr FA, Gleich GJ. Eosinophilic myocarditis manifesting as myocardial infarction: early diagnosis and successful treatment. Mayo Clin Proc. 1997;72:603–10.CrossRefGoogle Scholar
  10. 10.
    Fragkouli K, Mitselou A, Boumba V, Michalis L, Vougiouklakis T. An autopsy case of necrotizing eosinophilic myocarditis causing left ventricular wall rupture. Forensic Sci Med Pathol. 2011;7:350–4.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of MedicineComenius University, University HospitalMartinSlovak Republic
  2. 2.Department of Forensic Medicine, Faculty of MedicineCharles University and University HospitalHradec KraloveCzech Republic

Personalised recommendations