Eosinophilic myocarditis in a young female patient with bronchial asthma

The authors present probable eosinophilic myocarditis in a patient with bronchial asthma and seasonal allergic rhinitis, sensitization to pollen allergens. Myocarditis debuted in 3 weeks after viral infection (cardialgia and shortness of breath). ECG revealed violation of repolarization in anterior and high lateral segments of the left ventricle with negative T waves in leads V1—V3 and smoothed T waves in leads V4—V6, I and aVL. In winter, pain syndrome increased after a long journey by bus. ECG revealed deeper negative T waves in leads V1—V3, new deep negative T wave in leads V4—V5. There was high serum IgE (125 IU/ml) and eosinophilia. Intramural accumulation and delayed elimination of contrast agent were revealed on delayed 2D MDE series. MRI verified local myocardial edema as an objective criterion of myocardial damage. This case demonstrates atypical course of eosinophilic myocarditis with unclear symptoms, severe ECG changes and no classic laboratory abnormalities.