Loeffler endocarditis

Clinic

• Loeffler endocarditis is now regarded as a manifestation of eosinophilic myocarditis, a disorder that involves the infiltration of the heart's muscular layer by eosinophils that leads to three progressive clinical stages.
  1. The first stage involves acute inflammation and subsequent death of heart muscle cells. This stage is dominated by signs and symptoms of the acute coronary syndrome such as angina, heart attack, and congestive heart failure.
  2. In the second stage, the endocardium forms blood clots which break off and then travel through and block various arteries; this clotting stage may dominate the initial presentation in some individuals.
  3. The third stage is a fibrotic stage, i.e. Loeffler endocarditis, wherein scarring replaces damaged heart muscle tissue to cause a poorly contracting heart and/or heart valve disease.
• Recent publications commonly refer to Loeffler endocarditis as a historical term for the third stage of eosinophilic myocarditis.

Signs / Symptoms

The signs and symptoms of Loeffler endocarditis tend to reflect the many underlying disorders causing eosinophil dysfunction as well as the widely differing progression rates of cardiac damage.

Before cardiac symptoms are detected, individuals may suffer symptoms of Allergic disorder such as Common cold, Asthma, Rhinitis and Urticaria

• Cardiac manifestations include life-threatening conditions such as cardiogenic shock or sudden death due to abnormal heart rhythms.
• More commonly, however, the presenting cardiac signs and symptoms of the disorder are the same as those seen in other forms of cardiomyopathy: the heart arrhythmia of ventricular fibrillation seen as an irregular pulse and heart rate, other cardiac arrhythmias, symptoms of these arrhythmias such as chest palpitations, dizziness, light headedness, and fainting; and symptoms of a heart failure such as fatigue, edema, i.e. swelling, of the lower extremities, and shortness of breath.

• Hypereosinophilia / Eosinophilia is found in the vast majority of cases and are valuable clues pointing to this rather than other types of cardiomyopathies.