A hidden threat in the apical shadow: a case report regarding Loeffler endocarditis mimicking NSTEMI

Scritto il 06/07/2026
da Carlo Alberto Caruzzo

Eur Heart J Case Rep. 2026 Jul 4;10(7):ytag472. doi: 10.1093/ehjcr/ytag472. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Loeffler endocarditis (LE) is a rare but potentially life-threatening cardiac manifestation of hyper-eosinophilic syndrome (HES). The disease is often complicated by intracardiac thrombus formation and may lead to severe restrictive cardiomyopathy and thromboembolic events.

CASE PRESENTATION: We report the case of a 71-year-old man with long-standing idiopathic hyper-eosinophilia who presented with chest pain and progressive dyspnoea. Cardiac MRI revealed apical endocardial fibrosis with intracavitary thrombus, confirming a diagnosis of Loeffler endocarditis. The patient was successfully treated with corticosteroids and anticoagulation with vitamin K antagonists.

CONCLUSION: This case highlights the diagnostic challenges and therapeutic strategies in managing LE. Cardiac MRI is essential for diagnosis, and early initiation of steroids and anticoagulation significantly improves clinical outcomes.

PMID:42405235 | PMC:PMC13332496 | DOI:10.1093/ehjcr/ytag472