J Korean Soc Radiol.  2012 Feb;66(2):133-137. 10.3348/jksr.2012.66.2.133.

Churg-Strauss Syndrome with Cardiac Involvement: A Case Report with CT and MRI Findings

• Lim SJ
• Cho YJ
• Kim KW
• Hwang CM
• Kim DH
• Choi EG

• KMID: 1439404
• DOI: http://doi.org/10.3348/jksr.2012.66.2.133

Abstract

This is a case report of Churg-Strauss Syndrome (CSS) associated with cardiac involvement which is demonstrated in chest CT and cardiac MRI (CMR) without specific cardiac symptoms. A 32-year-old woman had a 3-year history of bronchial asthma, chronic sinusitis, and otitis media. The patient had various typical findings of CSS. The patient had no specific cardiac symptoms or signs such as chest pain, palpitations, syncope, or murmur, but she had diffuse low attenuation lesions in the inner wall of the left ventricle (LV) in contrast-enhanced CT. This corresponded to the area of subendocardial hyperenhancement in delayed contrast-enhanced CMR images. She was treated with steroids for 2 months. Follow-up delayed contrast-enhanced CMR of the LV showed a decrease in the size of the subendocardial enhancement area, and she had no symptoms. Therefore, the radiologist and clinician both should pay careful attention to observe possible cardiac involvement in case of CSS.

MeSH Terms

Adult
Asthma
Cardiomyopathies
Chest Pain
Churg-Strauss Syndrome
Female
Follow-Up Studies
Heart Ventricles
Humans
Magnetic Resonance Spectroscopy
Otitis Media
Sinusitis
Steroids
Syncope
Thorax
Steroids

Reference

1. Setoguchi M, Okishige K, Sugiyama K, Shimura T, Maeda M, Aoyagi H, et al. Sudden cardiac death associated with Churg-Strauss syndrome. Circ J. 2009. 73:2355–2359.

2. Shanks M, Ignaszewski AP, Chan SY, Allard MF. Churg-Strauss syndrome with myocarditis manifesting as acute myocardial infarction with cardiogenic shock: case report and review of the literature. Can J Cardiol. 2003. 19:1184–1188.

3. Choi YH, Im JG, Han BK, Kim JH, Lee KY, Myoung NH. Thoracic manifestation of Churg-Strauss syndrome: radiologic and clinical findings. Chest. 2000. 117:117–124.

4. Churg J, Strauss L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol. 1951. 27:277–301.

5. Pelà G, Tirabassi G, Pattoneri P, Pavone L, Garini G, Bruschi G. Cardiac involvement in the Churg-Strauss syndrome. Am J Cardiol. 2006. 97:1519–1524.

6. Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. 1990. 33:1094–1100.

7. Corradi D, Vaglio A, Maestri R, Legname V, Leonardi G, Bartoloni G, et al. Eosinophilic myocarditis in a patient with idiopathic hypereosinophilic syndrome: insights into mechanisms of myocardial cell death. Hum Pathol. 2004. 35:1160–1163.

8. Wassmuth R, Göbel U, Natusch A, Schneider W, Kettritz R, Dietz R, et al. Cardiovascular magnetic resonance imaging detects cardiac involvement in Churg-Strauss syndrome. J Card Fail. 2008. 14:856–860.