A hidden threat in the apical shadow: a case report regarding Loeffler endocarditis mimicking NSTEMI

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ID: 319654
2026
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Abstract
Abstract Background Loeffler endocarditis (LE) is a rare but potentially life-threatening cardiac manifestation of hyper-eosinophilic syndrome (HES). The disease is often complicated by intracardiac thrombus formation and may lead to severe restrictive cardiomyopathy and thromboembolic events. Case presentation We report the case of a 71-year-old man with long-standing idiopathic hyper-eosinophilia who presented with chest pain and progressive dyspnoea. Cardiac MRI revealed apical endocardial fibrosis with intracavitary thrombus, confirming a diagnosis of Loeffler endocarditis. The patient was successfully treated with corticosteroids and anticoagulation with vitamin K antagonists. Conclusion This case highlights the diagnostic challenges and therapeutic strategies in managing LE. Cardiac MRI is essential for diagnosis, and early initiation of steroids and anticoagulation significantly improves clinical outcomes.
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Authors C Caruzzo, Elia Rigamonti, Francesca Romana Scopigni, Anna Giulia Pavon, Marco Facchini
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag472
URL
Keywords Keywords not found

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