Successful Treatment of Acute Fulminant Eosinophilic Myocarditis in a Patient with Ulcerative Colitis Using Steroid Therapy and Percutaneous Cardiopulmonary Support

Minoru Tagawa; Yuichi Nakamura; Yuji Okura; Hitomi Nanba; Kenji Kishi; Erina Akashi; Yukie Ochiai; Yasuhiro Asai; Masaomi Chinushi

doi:10.2169/internalmedicine.1528-18

CASE REPORTS

Successful Treatment of Acute Fulminant Eosinophilic Myocarditis in a Patient with Ulcerative Colitis Using Steroid Therapy and Percutaneous Cardiopulmonary Support

Minoru Tagawa, Yuichi Nakamura, Yuji Okura, Hitomi Nanba, Kenji Kishi, Erina Akashi, Yukie Ochiai, Yasuhiro Asai, Masaomi Chinushi

Author information

Minoru Tagawa
Department of Cardiology, Nagaoka Chuo General Hospital, Japan
Yuichi Nakamura
Department of Cardiology, Nagaoka Chuo General Hospital, Japan
Yuji Okura
Department of Cardiology, Niigata Cancer Center Hospital, Japan
Hitomi Nanba
Department of Cardiology, Nagaoka Chuo General Hospital, Japan
Kenji Kishi
Department of Hematology, Nagaoka Chuo General Hospital, Japan
Erina Akashi
Department of Cardiology, Nagaoka Chuo General Hospital, Japan
Yukie Ochiai
Department of Cardiology, Nagaoka Chuo General Hospital, Japan
Yasuhiro Asai
Yuzawa Community Medical Center, Japan
Masaomi Chinushi
Graduate School of Health Science, Niigata University School of Medicine, Japan

Keywords: fulminant myocarditis, eosinophilic myocarditis, ventricular tachycardia, atrial-ventricular block, percutaneous cardiopulmonary support, steroid therapy

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 8 Pages 1111-1118

DOI https://doi.org/10.2169/internalmedicine.1528-18

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Abstract

A 47-year-old man with ulcerative colitis was transferred to our hospital due to progressive dyspnea. Electrocardiography on admission showed ST elevation in leads II, III, aVF, and V5-V6. Coronary angiography revealed no remarkable coronary stenosis, and left ventriculography showed a depressed left ventricular ejection fraction (EF) of 23%. Although the patient received percutaneous cardiopulmonary support, his EF progressively decreased (7-15%), and both ventricular tachycardia (VT) and high-degree atrial-ventricular block occurred. An endomyocardial biopsy showed eosinophilic infiltration in the myocardium. Steroid therapy improved the patient's EF. However, his severe inferior wall hypokinesis and non-sustained VT remained after the abovementioned treatment.

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