warfarin and Endomyocardial-Fibrosis

An Indian man in his late 30s presented with ischaemic stroke and eosinophilia of 711/mm(3). ECG showed first-degree heart block with ST depression and symmetrical T-wave inversions in the chest leads. Subsequently, the patient was further evaluated by echocardiography and cardiac MRI which identified the presence of endomyocardial fibrosis in the heart.

Topics: Adult; Anticoagulants; Brain Ischemia; Echocardiography, Transesophageal; Electrocardiography; Endomyocardial Fibrosis; Humans; Magnetic Resonance Imaging; Male; Stroke; Warfarin

A case of endomyocardial fibrosis in a patient with idiopathic hypereosinophilic syndrome is reported and discussed. The authors draw attention to the importance of both echocardiography (two-dimensional and Doppler) and nuclear magnetic resonance in the detection of cardiac involvement due to this rare pathology. Moreover, these imaging techniques appear to be valuable in the evaluation of effects of medical treatment. Therapy with corticosteroids alone has shown no reliable effectiveness in reducing the absolute eosinophil count. A combined immunosuppressive treatment with use of hydroxyurea is required.

Topics: Dipyridamole; Drug Therapy, Combination; Echocardiography, Doppler; Endomyocardial Fibrosis; Female; Humans; Hydroxyurea; Hypereosinophilic Syndrome; Magnetic Resonance Imaging; Middle Aged; Prednisone; Warfarin