Churg-Strauss Infarction
Report:
Sinus rhythm 75/min
SVEBs
Left ventricular hypertrophy with ST/T changes
ST/T changes also c/w infarction/ischaemia
Comment:
The patient was admitted with unstable angina but deteriorated over 24 hours into cardiogenic shock and died.
The ECG is suggestive of anteroseptal ischæmia or infarction. Echocardiogram showed dilated and hypertrophied ventricle with global systolic dysfunction most marked anteroseptally. Autopsy showed multiple focal areas of infarction secondary to allergic angiitis and granulomatosis (Churg-Strauss syndrome) and eosinophilic pericarditis. The coronary arteries showed extensive atheroma burden, but without critical flow-limiting stenoses. The heart weighed 500 g. There was widespread involvement of lungs and other organs.
The trace below (Fig 39a), taken in ICU a few hours before death, shows incomplete LBBB, with loss of septal q waves in 1 and aVL and r waves in V1-2.
Despite peripheral eosinophilia and pulmonary infiltrates (looking like œdema) the cardiac diagnosis was a surprise – one of those that delight the pathologists. Ischæmic syndromes due to vasculitides are well recognised38 but remain zebras in the daily life of the hospital.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and it's records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.