Idiopathic Hypereosinophilic Syndrome Presenting as Isolated Right Ventricular Endomyocardial Fibrosis With Intracavitary Thrombus: A Multimodality Imaging Case Report

Description

Nadia Loudiyi leads a five-author team reporting a 2026 cardiology case of a rare blood disorder scarring the inside of the heart. A 55-year-old man arrived with a month of worsening swelling in both legs. Blood tests showed striking, persistent hypereosinophilia, an excess of eosinophil white cells, alongside raised cardiac injury markers. Ultrasound revealed a large mass filling much of the right ventricle, nearly sealing its apex. The picture fit idiopathic hypereosinophilic syndrome, where the cells themselves damage organs.

Magnetic resonance imaging confirmed diffuse scarring under the right ventricle's inner lining, the endomyocardial fibrosis pattern, plus an associated clot inside the cavity. CT scans excluded a lung embolism and cancer, while an exhaustive hunt through blood, marrow, and molecular tests found no infectious, autoimmune, or clonal cause. Treatment combined high-dose corticosteroids, a vitamin K antagonist blood thinner, and diuretics. The authors credit layered imaging for untangling the mimicry.

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Source: https://europepmc.org/article/MED/PMC13502146