REVIEW   Open access

Minerva Cardiology and Angiology 2023 Aug 07

DOI: 10.23736/S2724-5683.23.06297-X

Copyright © 2023 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.

language: English

Eosinophilic myocarditis: from etiology to diagnostics and therapy

Marco RUSSO ¹ ✉, Zumrud ISMIBAYLI ², Serena ANTONACI ¹, Giovanni C. PICCINNI ¹

¹ Unit of Cardiology, Sacro Cuore di Gesù Hospital, Gallipoli, Lecce, Italy; ² Unit of Cardiology, XMSK Hospital, Baku, Azerbaijan

Eosinophilic myocarditis (EM) is a rare, potentially life-threatening, form of inflammatory heart disease characterized by eosinophilic infiltration of the myocardium. Different diseases are involved in its etiopathogeneses, such as eosinophilic granulomatosis with polyangiitis (or Churg-Strauss Syndrome), hypereosinophilic syndromes, parasitic infections, drug reactions, paraneoplastic syndromes and primary immunodeficiencies (e.g. Omenn Syndrome). There is a wide spectrum of clinical pictures at presentation ranging from chronic restrictive cardiomyopathy (Loeffler cardiomyopathy) to acute necrotizing myocarditis with cardiogenic shock. The genetic contribution and the environmental interplay, such as SARS-CoV-2 infection and related vaccines, are fields not well studied yet. Many non-invasive tools, mainly echocardiography and cardiac magnetic resonance imaging, along with invasive procedures, such as endomyocardial biopsy, are the crucial steps in the diagnostic workup. The correct diagnosis is a challenge but mandatory for timely and appropriate immunosuppressive therapy.

KEY WORDS: Myocarditis, Eosinophils; Churg-Strauss syndrome; Granulomatosis with polyangiitis; Hypereosinophilic syndrome