Eosinophilic granulomatosis with polyangiitis, asthma as the first symptom, and subsequent Loeffler endocarditis: A case report

Figure 1 Treatment Response Indicators Post-Therapy with Methylprednisolone Sodium Succinate and Mycophenolate Mofetil. Rapid reductions in Eosinophil (E%), cardiac troponin T, and N-terminal pro-B-type natriuretic peptide following treatment are presented. cTnT: Cardiac troponin T; NT-proBNP: N-terminal pro-B-type natriuretic peptide.

Figure 2 Electrocardiogram upon patient admission. Displayed findings include a sinus rhythm at 93 bpm, ST-segment depression, T-wave inversion in leads II, III, aVF, and V1-V3, and the presence of an SITIII manifestation.

Figure 3 Comparative echocardiogram and chest computed tomography imaging pre- and post-treatment. A: Chest computed tomography (CT; lung window image) from March 30, 2023; B and C: Pre-treatment echocardiogram illustrating right ventricular enlargement and a hypoechoic mass (dimensions: 25 mm × 24 mm × 38 mm) in the right ventricular wall; C: Significant regurgitation observed at the tricuspid valve; D: Comparative chest CT from April 7, 2023, post one week of glucocorticoid treatment, displaying diminished exudative foci in both lungs; E: Post-treatment echocardiogram indicating a tricuspid regurgitation peak flow rate of 231 cm/s, and a differential pressure of 21 mmHg, suggestive of regular systolic right ventricular pressure; F: Reduced echo size of right ventricular thrombus post-treatment.

Figure 4 Cardiovascular magnetic resonance imaging illustrating cardiac changes. A: Enlarged right atrial volume and thickened right ventricular endocardium; B: Central right ventricle displaying a low-signal filling defect; C: Myocardial first-perfusion highlighting a perfusion defect in the right ventricle with arcuate hypoperfusion areas located in the septum and right ventricular subendocardium; D: Delayed enhancement image illustrating no right ventricular enhancement; E: Delayed enhancement depicting high signal shadows present in the ventricular septum and on both ventricular walls; F: Delayed enhancement image showing minimal pericardial effusion and thickened pericardium.