A 56-year-old woman with breathlessness.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 27899427.
- Also identified by DOI 10.1136/heartjnl-2016-310611 and PMC identifier 5529977.
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Abstract
A 56-year-old female with adult-onset asthma was admitted to the cardiology service with intermittent left-sided chest pain and progressive dyspnoea. Twelve months prior to this admission, she had received a course of prednisolone for bilateral anterior uveitis. Physical examination was unremarkable with blood sampling revealing a marked eosinophilia (eosinophil count 17.3×10<sup>9</sup>/L) and a perinuclear antineutrophil cytoplasmic antibody staining pattern on indirect immunofluorescence microscopy (myeloperoxidase antibodies 83 IU/mL). ECG demonstrated anterolateral T-wave inversion (see online supplementary figure S1). High-sensitivity troponin T was elevated at 100 ng/L. Invasive coronary angiography showed unobstructed coronary arteries. Echocardiography and cardiac magnetic resonance (CMR) were performed (figure 1). What is the most appropriate therapy? Beta-blockade and ACE inhibitionMethylprednisoloneIntravenous antibioticsEndocardiectomyImplantable cardioverter defibrillator (ICD).
Medical subject headings
- Churg-Strauss Syndrome
- Dyspnea
- Eosinophilia
- Myocarditis