Department of Cardiology, Case Medical Center, Cleveland, Ohio 44106, USA.
Ann Thorac Surg. 2012 Mar;93(3):974-7. doi: 10.1016/j.athoracsur.2011.08.062.
Idiopathic hypereosinophilic syndrome (HES) is a rare multisystem condition characterized by dysregulated overproduction of eosinophils. Cardiac involvement in HES is characterized by necrosis from infiltration of eosinophils and thrombus formation and, in the late stage, by fibrosis and chronic valvular regurgitation. We report a very unusual presentation of idiopathic HES with acute mitral regurgitation due to papillary muscle rupture. The transesophageal echocardiogram was suggestive of a flail posterior leaflet and suspicious for endocarditis. Intraoperatively, papillary muscle rupture was seen and the patient underwent mitral valve replacement. The pathologic examination of the valve revealed eosinophilic infiltration of the papillary muscle. The patient was treated with steroids and responded well clinically.
特发性嗜酸性粒细胞增多综合征（HES）是一种罕见的多系统疾病，其特征是嗜酸性粒细胞失调性过度生成。HES 中的心脏受累表现为嗜酸性粒细胞浸润和血栓形成引起的坏死，晚期则表现为纤维化和慢性瓣膜反流。我们报告了一例非常罕见的特发性 HES 病例，表现为乳头肌断裂导致的急性二尖瓣反流。经食管超声心动图提示后叶瓣游离，并疑似心内膜炎。术中发现乳头肌断裂，患者接受了二尖瓣置换术。瓣膜的病理检查显示乳头肌中有嗜酸性粒细胞浸润。患者接受了类固醇治疗，临床反应良好。
