Myocardial involvement in eosinophilic granulomatosis with polyangiitis: a multimodal approach.

Abstract

Almost 7 million patients with chest discomfort present to emergency department in United States every year and differential diagnosis includes a broad spectrum of pathologies, being up to 20% of cardiovascular cause, and up to 5.5% of these are life-threatening conditions1. Differential diagnosis board should include other causes besides acute coronary syndrome. Systemic vasculitides are classified in order of affected vessel size (large, medium, or small vessel)2,3. Heart involvement is related to a worst prognosis4 and could be affected on almost all type of vasculitides2, especially on medium vessel and small vessel (Eosinophilic granulomatosis with polyangiitis [EGPA] and granulomatosis with polyangiitis [GPA], which are part of the ANCA associated vasculitis). Even though EGPA is less prevalent than GPA, heart is more frequently affected on the first one4. This paper presents the case of a young female patient with fever, chest pain, and cough with a systemic vasculitis as the cause of myocardial damage.