Work

An Unusual Case of Pulmonary Embolism Leading to the Diagnosis of Eosinophilic Granulomatosis With Polyangiitis

Year: 2025

Type: article

Abstract: BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis that can present with eosinophilic myocarditis (EM). We present a rare presentation of EGPA with right ventricle (RV) thrombus and pulmonary embolism (PE). CASE SUMMARY: A 36-year-old male presented with chest pain and elevated troponin. The echocardiogram showed normal left ventricular size and global systolic function but a moderately dilated RV with mildly reduced systolic function. The cardiac tomography angiography of the chest identified a PE and raised suspicion for RV enlargement and possible thrombus. Cardiac magnetic resonance imaging revealed diffuse subendocardial late gadolinium enhancement and wall thickening in the RV raising concern for EM. He was started on anticoagulation, corticosteroids, and immunosuppressants with complete resolution noted in repeat magnetic resonance imaging in 9 months. DISCUSSION: RV thrombus with PE in EGPA-associated EM is rare, with few cases reported. TAKE-HOME MESSAGE: Early recognition with advanced imaging and timely intervention can prevent fatal complications in patients with EM.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105005

Authors: Gunjan Kochhar, Mukta Agrawal, Mohit Pahuja

Institution: University of Oklahoma Health Sciences Center

Language: English

Topic: Vasculitis and related conditions

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850