[Surgical treatment of the hypereosinophilic syndrome with cardiac involvement (Löffler's endocarditis)].

UNLABELLED: HISTORY AND LABORATORY FINDINGS: A 38-year-old woman presented for further treatment of heart failure with NYHA class III symptoms and the idiopathic eosinophilia syndrome. Differential blood count had previously revealed an eosinophilia of 19%, which had fallen to normal under immunosuppression .

INVESTIGATIONS: Echocardiography demonstrated echo-rich material in the left ventricular (LV) apex, severe mitral regurgitation and a restriction pattern in the transmitral flow profile. Magnetic resonance imaging (MRI) additionally showed a parietal thrombus sitting on the echo-rich mass in the LV apex.

TREATMENT AND COURSE: Surgical LV endocardial resection and allogenic mitral valve replacement were performed. At follow-up (currently four years after the operation) the patient reported marked improvement of symptoms. Echocardiography and MRI demonstrated a normal configuration of the LV apex.

CONCLUSION: While endomyocardial fibrosis usually has a poor prognosis, this case illustrates hat surgical treatment of an associated mitral regurgitation can in selected cases be successful.