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October 1974

Eosinophilic Endomyocarditis Complicating Acute Myocardial Infarction: Involvement of the Cardiac Conduction System

Author Affiliations

From the departments of pathology (Dr. Lie) and cardiology (Dr. Hunt), Royal Melbourne Hospital, Australia. Dr. Lie is now with the Department of Pathology, Baylor College of Medicine, Houston.

Arch Intern Med. 1974;134(4):754-757. doi:10.1001/archinte.1974.00320220156023

Eosinophilic endomyocarditis (Loeffler endocarditis1) is characterized by blood eosinophilia, refractory congestive heart failure, endomyocarditis progressing to replacement fibrosis, and extensive intracardiac mural thrombosis with frequent peripheral embolic complications.1-4 It may occur as an isolated clinicopathologic entity or as part of a broad spectrum of "hypereosinophilic syndromes,"5 including such diverse conditions as eosinophilic leukemia,6 pulmonary infiltration with eosinophilia (PIE syndrome),7 eosinophilic gastroenteropathy,8 and disseminated eosinophilic collagen disease.9 We believe the case to be described is unique because, clinically, the patient died from acute myocardial infarction associated with cardiogenic shock and conduction disturbances. Autopsy confirmed the diagnosis but also revealed an unsuspected eosinophilic endomyocarditis with involvement of the conduction system of the heart.

Patient Summary  A 60-year-old Finnish migrant had a history of four hospital admissions in Sweden because of chest pain, the last being in May 1968. When first seen at this hospital in July

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