Abstract
A 73-year-old Japanese woman was admitted to the intensive care unit of our hospital with the diagnosis of eosinophilic pneumonia and congestive heart failure. Laboratory examination revealed a white blood cell count of 8100/mm3 with 49% eosinophils, 1568 IU/mL IgE, 467 IU/L lactate dehydrogenase with 40% lactate dehydrogenase-1, a brain natriuretic peptide level of 1223 pg/mL, and 23.5 U/mL myeloperoxidase anti-neutrophil cytoplasmic antibody. Chest x-ray demonstrated bilateral perihilar opacities. ECG showed normal sinus rhythm and QS pattern in leads V1 through V5. Transthoracic echocardiography (TTE) demonstrated severe thickening and hyperkinesis of the posterior portion of the left ventricular (LV) wall during diastole and systole (Figure 1A and 1B, arrows and Movies I–III in the online-only Data Supplement), which caused the Doppler-derived systolic pressure gradient across the LV outflow tract of 74 mm Hg. Transmitral flow pattern showed an E/A ratio of 2.1 with a deceleration time of 58 milliseconds, suggesting severe …
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