To describe the Cardiac Magnetic Resonance (CMR) findings in Eosinophilic Myocarditis (EM), and raise awareness on non-ischemic conditions causing subendocardial enhancement. To understand the pathophysiology of this disease and its representation on CMR.

After diagnosing EM in a patient in our hospital, we reviewed our data base of CMR over a 10-year period looking for similar cases. We found 5 cases of EM. Hypereosinophilia was due to primary hypereosinophilic syndrome (n=2), toxocara infection (n=1) and Churg-Strauss syndrome (n=2). CMR findings are analysed at presentation and follow-up (3 CMR in 3 cases and 2 CMR in 2). Pathophysiology and progression of eosinophilic heart disease are reviewed to understand imaging findings on CMR.

CASE REPORTS We present five cases of EM: 4 females and 1 male, medium age 54,8 years (range: 37- 72). None of them had a history of coronary artery disease, although only in one case angiography was performed to rule out significant stenosis in coronaries. No history of atherosclerotic disease was present in any patient, and cardiovascular risk factors were only found in a 69-years-old female (smoking). In every case except one (toxocariasis case), eosinophilia was already known at the time of performing CMR. Hypereosinophilic...

EM is a rare cardiac disorder that may present on CMR with subendocardial enhancement. A misdiagnosis of myocardial infarction can be made, especially if eosinophilia is not previously known. Blood eosinophilia and normal coronaries should raise the suspicion of EM. CMR has an important role in diagnosis of EM, although further studies are needed to define clinical relevance of subendocardial enhancement in these patients.

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