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Clin Med Insights Case Rep. 2017 Aug 30;10:1179547617723643. doi: 10.1177/1179547617723643. eCollection 2017.

Loeffler Endocarditis: A Unique Presentation of Right-Sided Heart Failure Due to Eosinophil-Induced Endomyocardial Fibrosis.

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Division of Cardiovascular Diseases and Hypertension, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Department of Internal Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, USA.
Department of Cardiology, Hofstra Northwell School of Medicine, Manhasset, NY, USA.
Department of Radiology, Hofstra Northwell School of Medicine, Manhasset, NY, USA.
Department of Cardiology, St. Francis Hospital, Roslyn, NY, USA.


Loeffler endocarditis is a rare restrictive cardiomyopathy caused by abnormal endomyocardial infiltration of eosinophils, with subsequent tissue damage from degranulation, eventually leading to fibrosis. Although an uncommon entity, it is still a disease with significant morbidity and mortality. Often identified only at late stages, treatment options are limited once fibrosis occurs, usually requiring heart failure medications or surgical intervention. We present a unique case of a woman with remote history of hypereosinophilic syndrome, attributed to treatment of rheumatoid arthritis with infliximab, who presented with symptoms of heart failure refractory to medical management and was found to have Loeffler endocarditis. The severe progression of the disease required surgical intervention with endocardial stripping to treat the right-sided diastolic heart failure.


Loeffler endocarditis; endocardial stripping; eosinophilic cardiomyopathy; hypereosinophilic syndrome

Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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