CTICasesLoeffler's Endocarditis (Fibrotic Phase)
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Imaging findings
Cardiac MRI showed striking subendocardial hypoperfusion in both ventricles (mid-cavity and apical levels, and RV). Initial studies showed significant ventricular thrombus. Follow-up imaging demonstrated transformation of prior thrombus into a fibrous ball of tissue and widespread subendocardial delayed enhancement in both ventricles, indicating progression to a fibrotic phase.
Key takeaways
Loeffler's endocarditis, or eosinophilic endocarditis, is a progressive disease with exudative, thrombotic, and fibrotic phases. Imaging reflects this progression, with early thrombus formation giving way to extensive subendocardial fibrosis and delayed enhancement in later stages.
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