Cardiac Involvement in Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Disease): The role of cardiovascular magnetic resonance

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss disease, is a rare vasculitis that affects small- to medium-sized vessels and has a propensity to involve the heart. Patients with cardiac involvement have a poor prognosis and usually require immunosuppressive treatment along with corticosteroids. Cardiovascular magnetic resonance (CMR) is a non-invasive diagnostic tool for detecting cardiac involvement and guiding the management plan. We report a 39-year-old male patient with a known history of bronchial asthma who was referred to the chest clinic at a tertiary hospital in 2019 for further assessment of persistent lung parenchymal changes on chest computed tomography. Given the clinical context of the patient and the radiological findings, EGPA was suspected and confirmed with a lung biopsy. CMR was performed for further assessment, which confirmed cardiac involvement. The patient was started on prednisolone and azathioprine and showed significant radiological and clinical improvement.

Keywords: Eosinophilic Granulomatous Vasculitis; Vasculitis; Eosinophils; Vascular Diseases; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Case Report; Oman.