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A good outcome of a case with eosinophilic myocarditis.

A 68-year-old man was admitted to our hospital with a suspected diagnosis of Churg-Strauss syndrome. A two-dimensional echocardiogram revealed anterior-apex hypokinesis with an ejection fraction (EF) of 45%. After an endomyocardial biopsy, we immediately started intravenous methylprednisolone at 1,000 mg/day for 3 days, followed by oral administration of prednisolone at 35 mg/day. A histopa-thology evaluation revealed endomyocardial eosinophilic in-filtration and degranulation in the interstitial space, suggest-ing a diagnosis of eosinophilic myocarditis. After starting corticosteroid therapy, he experienced a dramatic improvement of his symptoms. A cardiovascular magnetic resonance (CMR)-study after steroid pulse therapy showed anterior-apex hypokinesis (arrows in Picture A) with an EF of 48%. Electrocardiography showed left axis deviation with nonspe-cific T wave changes during treatment. After three months, late gadolinium enhancement was not detected, and there was an improvement of the anterior-apex wall motion (Pic-ture B) and EF (70%). This case highlights the clinical im-portance of the prompt initiation of steroids for eosinophilic