We describe a male adult patient who presented with chest discomfort and shortness of breath. A diagnosis of cardiac tamponade was made by transthoracic echocardiogram. Urgent pericardiocentesis was performed and analysis of pericardial fluid showed presence of eosinophil. Complete blood picture showed peripheral eosinphilia as well. Subsequent work up for eosinophilia showed ova of Clonorchis sinesis from the stool thus a course of praziquantel was given. Transient clinical improvement and lowering of eosinophil count were observed but two weeks later he developed acute coronary syndrome. Urgent coronary angiogram showed coronary vasospasm. Endomyocardial biopsy was performed afterwards which showed marked eosinophilic infiltrate. Bone marrow biopsy and skin biopsy showed marked marrow eosinophilia and leucocytoclastic vasculitis with abundant eosinophils, respectively. A diagnosis of hypereosinophilic syndrome was made after exclusion of secondary and clonal eosinophilia. After oral steroid was given, his condition was stabilized and the eosinophil count was normalized.
Kwok-Leung Wu, Kin-Lam Tsui, Ka-Lai Lee, Sung-Yu Liu, A Rare Cause of Cardiac Tamponade: Hypereosinophilic Syndrome Journal of the Hong Kong College of Cardiology 2012;20(2) https://doi.org/10.55503/2790-6744.1046