An unusual cause of left ventricular mass

Churg-Strauss syndrome (CSS) is a rare necrotizing vasculitis of small- and medium-size blood vessels, characterized by granulomas and hypereosinophilia with organ involvement. Cardiac involvement in these patients is a poor prognostic factor and accounts for 50% of deaths. CSS can affect any layer of the heart, and ischemia secondary to vasculitis and/or eosinophilic infiltration are the two proposed mechanisms for this type of involvement. Several imaging modalities, such as two-dimensional echocardiogram, positron emission tomography and cardiac magnetic resonance, have been used to detect cardiac involvement in CSS patients. Mortality is as high as 50% without immediate therapy, and usual regimens include intravenous steroids and cyclophosphamide. The authors present a case involving a 48-year-old man newly diagnosed with CSS presenting with a left ventricular mass resolved with steroid therapy.