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Open Access Case report

Löffler endocarditis: a rare cause of acute cardiac failure

Nicolasine D Niemeijer12*, Paul LA van Daele1, Kadir Caliskan3, Frans BS Oei4, Olaf JL Loosveld2 and Nardo JM van der Meer5

Author Affiliations

1 Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands, P.O. Box 2040, , 3000, CA, Rotterdam, the Netherlands

2 Department of Internal Medicine, Amphia Hospital, Breda, the Netherlands

3 Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands

4 Department of Cardio-Thoracic Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands

5 Department of Anaesthesiology and Intensive Care Medicine, Amphia Hospital, Breda and Oosterhout, the Netherlands

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Journal of Cardiothoracic Surgery 2012, 7:109  doi:10.1186/1749-8090-7-109

Published: 10 October 2012

Abstract

We describe a patient with acute cardiogenic shock due to cardiac involvement in idiopathic hypereosinophilic syndrome (Löffler endocarditis). At the echocardiography, there was a huge mass in the left ventricular cavity, resulting in inflow- and outflow tract obstruction. The posterior leaflet of the mitral valve apparatus was completely embedded in a big (organized) thrombus mass. The patient was treated with high dose corticosteroids, however without effect. Partial remission was achieved after treatment with hydroxycarbamide. He was also treated with anticoagulants and high dose beta-blockers. The patient’s condition improved remarkably after correction of the mitral valve insufficiency by a mitral valve bioprosthesis.

Keywords:
Hypereosinophilic syndrome; Cardiac thrombus; Cardiac failure; Löffler endocarditis