Loeffler’s endocarditis – a rare case of restrictive cardiomyopathy

Abstract

The association between eosinophilia, active carditis and multiorgan failure was first described in 1936 by the Swiss physician Wilhelm Lоfler. Loeffler’s endocarditis and endomyocardial fibrosis are presented as two rare forms of hypereosinophilic syndrome. Loeffler’s endocarditis (EL) is a restrictive model of cardiomyopathy, the clinical manifestations of which are associated with signs of severe heart failure. Intraventricular thrombosis is often found in him. Manifestations of thromboembolism, such as transient ischemic attacks, splenic ischemia, and thromboembolic events involving the coronary arteries, often presented with the clinical picture of acute coronary syndrome, are part of the manifestation of the disease. Disguise from the clinical manifestation of large nosological units such as acute myocardial infarction, stroke, parasitosis would complicate the correct diagnostic approach. The characteristic echocardiographic finding and the data for eosinophilia are indicative in the first stage. The gold standard for diagnosis is endomyocardial biopsy with subsequent histological examination, as well as magnetic resonance imaging. Early detection of the disease is crucial for the patient’s prognosis. Without  specific treatment, the prognosis is bad and associated with increased mortality. We present a clinical case of a 63-year-old patient with a restrictive model of cardiomyopathy. The characteristic echocardiography and clinical findings were highly suspected of endomyocardial disease, which was confirmed histologically. After starting the specific therapy required for the disease, the patient has an excellent response to symptoms and achieved clinical remission.