Eosinophilic myocarditis in platelet-derived growth factor receptor α-rearranged myeloid neoplasm with central nervous system involvement: a case report

Eosinophilic myocarditis is a rare inflammatory condition caused by eosinophilic infiltration of the myocardium, often associated with systemic or hematologic disorders. We report a 31-year-old man with a newly diagnosed platelet-derived growth factor receptor α-rearranged myeloid neoplasm who presented with acute chest pain and elevated cardiac biomarkers. Echocardiography showed Loeffler-type apical involvement, coronary computed tomography angiography excluded obstructive coronary disease, and cardiac magnetic resonance (CMR) demonstrated acute non-ischemic inflammatory myocardial injury. During hospitalization, neurological symptoms revealed central nervous system involvement by the underlying myeloid neoplasm. Corticosteroids and targeted hematologic treatment resulted in marked clinical and radiologic improvement. On long-term follow-up, CMR showed normal cardiac function with complete resolution of the inflammatory myocardial abnormalities and no residual fibrosis. This case highlights the value of early multimodality cardiac imaging, etiologic diagnosis, and coordinated cardio-hematologic management in recognizing potentially reversible eosinophilic myocardial injury and limiting progression to irreversible cardiac sequelae.