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Acute Necrotizing Eosinophilic Myocarditis as a Manifestation of Severe Hypersensitivity Myocarditis
Antemortem Diagnosis and Successful Treatment
- Mark A. Getz, MD;
- Ramiah Subramanian, MD;
- Tim Logemann, MD; and
- Ford Ballantyne, MD
Excerpt
Acute necrotizing eosinophilic myocarditis is characterized by acute and fulminant congestive heart failure that has previously been uniformly fatal (1, 2). Predisposing factors include an initial viral infection and an underlying allergic diathesis. This disease's pathologic characteristics include eosinophilic and lymphocytic infiltration with extensive myocardial cell necrosis and no notable extracardiac pathologic findings. Hypersensitivity myocarditis is characterized by rash, fever, sinus tachycardia, and eosinophilia related to a drug allergy. This entity is also characterized by eosinophilic and lymphocytic infiltration of the myocardium, but necrosis is uncommon (3). Patients with hypersensitivity myocarditis usually are not critically ill, and they respond to
Article and Author Information
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From the University of Wisconsin Medical School and the William S. Middleton Memorial Veterans Affairs Hospital, Madison, Wisconsin. For current author addresses, see end of text.
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Grant Support: In part by the Medical Research Service, U.S. Department of Veterans Affairs.
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Requests for Reprints: Ramiah Subramanian, MD, Section of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
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Current Author Addresses: Drs. Getz, Logemann, and Ballantyne: University of Wisconsin Hospital, 600 Highland Avenue, Madison, WI 53792.
Dr. Subramanian: Section of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
