Large left ventricular non-infectious vegetation in patient with eosinophilic granulomatosis with polyangiitis

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of systemic vasculitis in which cardiac involvement is relatively common and accounts for half of EGPA-related deaths. Cardiac involvement is more frequent in patients with an absence of anti-neutrophil cytoplasmic antibody and those with higher eosinophil counts. Clinical manifestations are various, including myocarditis, pericarditis, pericardial effusion, heart failure, arrhythmias, valvular insufficiencies and intra-cardiac thrombus formation. The pathology of cardiac involvement in EGPA is usually endomyocardial and pericardial eosinophilic infiltration. Considering the potentially adverse outcomes associated with cardiac involvement in EGPA, early detection is important. We experienced a rare case of EGPA with cardiac involvement presenting with noninfectious vegetations.