Hypereosinophilic syndrome with characteristic left ventricular thrombus demonstrated by contrast echocardiography

Hypereosinophilic syndrome (HES) is a rare condition characterised by idiopathic cosinophilia with organ system involvement. The condition is far more common in males, with a typical onset in the third to sixth decade. Cardiac damage may result in the formation of a characteristic apical thrombus readily visualised on two-dimensional echocardiography. Cardiac involvement portends a less favourable prognosis as it can be complicated by acute embolic events and progressive development of restrictive cardiomyopathy, valvular dysfunction, and heart failure. In this case report, we describe a middle-aged gentleman with HIES and characteristic apical thrombus identified on contrast echocardiography. Although the use of contrast agents for assessment of left ventricular thrombus is documented in the literature, this case illustrates the application of contrast echocardiography in the evaluation of eosinophilia. (Neth Heart J 2009;17:169-70.)