Successful treatment of acute fulminant eosinophilic myocarditis in a patient with ulcerative colitis using steroid therapy and percutaneous cardiopulmonary support

Abstract

A 47-year-old man with ulcerative colitis was transferred to our hospital due to progressive dyspnea. Elec-trocardiography on admission showed ST elevation in leads II, III, aVF, and V5-V6. Coronary angiography revealed no remarkable coronary stenosis, and left ventriculography showed a depressed left ventricular ejection fraction (EF) of 23%. Although the patient received percutaneous cardiopulmonary support, his EF progressively decreased (7-15%), and both ventricular tachycardia (VT) and high-degree atrial-ventricular block occurred. An endomyocardial biopsy showed eosinophilic infiltration in the myocardium. Steroid therapy improved the patient’s EF. However, his severe inferior wall hypokinesis and non-sustained VT remained after the abovementioned treatment.