Key result
High-dose corticosteroids and hydroxyurea linked to aortic valve thrombus regression in hypereosinophilic syndrome.
Why the study?
Hypereosinophilic syndrome is a rare cause of ST-elevation myocardial infarction and thrombus formation on the aortic valve that requires clinical characterization.
Case Report (n=1)
Hypereosinophilic syndrome should be considered as a rare cause of STEMI and cardiac thrombus formation, which can be effectively managed with immunosuppressive therapy.
May support considering HES in unexplained STEMI or valve thrombus; single case leaves open need for prospective validation.
We present a case of a man in his 30s presenting with ST-segment elevation myocardial infarction and eosinophilia. The patient underwent thrombus aspiration and initially echocardiographic evaluation was normal. The patient was discharged after 2 days, but was hospitalised again after 6 days. Echocardiographic evaluation now revealed a thrombus formation on the aortic valve. Laboratory data revealed increasing eosinophilia, and treatment with high-dosage corticosteroids and hydroxyurea was initiated as eosinophilic disease with organ manifestations could not be precluded. Eosinophils normalised and the patient was discharged again. The combination of hypereosinophilia and absence of infection, rheumatological disorders and malignancy, led to reactive or idiopathic hypereosinophilic syndrome being the most plausible diagnoses. The patient was closely monitored in the cardiology and haematology outpatient clinics. Echocardiographic evaluation, performed 6 weeks after the patient was discharged, showed significant regression in the size of the thrombus mass.
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Jørgensen et al. (2024) conducted a case report in ST-elevation myocardial infarction and hypereosinophilic syndrome (n=1). High-dosage corticosteroids and hydroxyurea was evaluated on Clinical course and echocardiographic evaluation. Treatment with high-dosage corticosteroids and hydroxyurea normalized eosinophils and led to significant regression of the aortic valve thrombus mass at 6 weeks in a man with hypereosinophilic syndrome.
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