J Cardiovasc Ultrasound.  2014 Dec;22(4):224-227. 10.4250/jcu.2014.22.4.224.

Cardiac Involvement in Hypereosinophilia Associated with Toxocariasis

• Park HJ
• You GI
• Cho KI
• Yang JW
• Kim SY
• Kim HS
• Cha TJ

• KMID: 1980428
• DOI: http://doi.org/10.4250/jcu.2014.22.4.224

Abstract

Cardiac involvement in hypereosinophilia is rare; when present, it manifests as ventricular thickening, usually with fibrous tissue and mural thrombosis. We present a case of a 57-year-old man with an abnormal right ventricular apex with eosinophilia, which was caused by Toxocara canis infection.

Keyword

Eosinophilia; Toxocara canis; Echocardiography

MeSH Terms

Echocardiography
Eosinophilia
Humans
Middle Aged
Thrombosis
Toxocara canis
Toxocariasis*

Figure

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  Fig. 1 Electrocardiography demonstrated atrial flutter with a ventricular rate of 77 bpm (A). Chest radiograph showed cardiomegaly and blunting of the bilateral costophrenic angles (B).

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  Fig. 2 Transthoracic echocardiography showed an enlarged right atrium with spontaneous echo contrast without a definite thrombus and a normal left ventricular ejection fraction.

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  Fig. 3 There was a moderate pericardial effusion (A) and dense right ventricular apical trabeculations with a large hypoechogenic mass (arrow) occupying the apex (B).

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  Fig. 4 Right ventricular apical trabeculations with a hypoechogenic mass (arrow) occupying the apex existed 3 months prior at the outside hospital (A). A right atrial thrombus existed at that time (B), which disappeared after anticoagulation.

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  Fig. 5 After pericardiostomy, the pericardial effusion disappeared (A), and the dense right ventricular apical mass (arrow) was not altered (B).

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  Fig. 6 Chest computerized tomography showed a relatively hypodense, thickened right ventricular apical endomyocardium (A). Cardiac magnetic resonance imaging showed a thickened, hypodense right ventricular apex (white arrow, B) and hyperenhancement of the endomyocardial border (black arrow) was shown after administration of gadolinium (C).

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