2026 FSA Podium and Poster Abstracts

Introduction: Loeffler’s endocarditis is a severe and rare manifestation of idiopathic hypereosinophilic syndrome. Hypereosinophilic syndrome (HES) is a condition that presents in 20-50 year olds with a diffuse range of symptoms secondary to eosinophils targeting multiple systems including cardiac. Loeffler’s endocarditis is associated with dyspnea on exertion, stroke-like symptoms, restrictive cardiomyopathy, and valvular degeneration. Anesthesiologists play a key role in management of patients perioperatively and post operatively with drug management. Understanding the physiology of patients with valvular insufficient and restrictive cardiomyopathy is important when coming up with a preop plan for patient management. Patients with filling defects due to restrictive cardiomyopathy from Loeffler’s endocarditis can delay the anesthetic drug's effects, therefore attenuating preop anesthesia care plans. Early detection is critical and clinical suspicion should be present for patients who lack risk factors that present with similar clinical manifestations such as embolic disease and cardiomyopathy. Early detection guides proper diagnostic intervention and appropriate treatment.The case presented depicts the importance of recognition and diagnosis of Loeffler’s endocarditis and the current evidence backed  treatment.

Case Report: A 25 year old female presented with dizziness, visual field deficits and syncope. The patient had a previous diagnosis of Unspecified Hypereosinophilic syndrome.. The patient followed up with a transthoracic echocardiogram (TTE),TEE, and cardiac MRI. The tests showed eosinophilic myocarditis, endomyocardial fibrosis, and mitral valve fibrosis with mitral regurgitations and mitral stenosis. 

The patient underwent median sternotomy for mitral valve replacement with a mechanical valve, and ligation left atrial appendage. 

Discussion/Conclusion: Loeffler’s Endocarditis is a rare manifestation of HES with a complicated disease course. Symptoms are vast due to the three stages the disease progresses through: acute necrotic stage, thrombotic stage and finally fibrotic stage. Patients often do not present with clear sequential progression and symptoms frequently overlap the various stages.For example, the patient presented with coexisting stages. Early detection is vital to prevent reaching the irreversible fibrotic stage which requires a more invasive form of treatment. TTE serves as the first line imaging for suspected Leoffler’s Endocarditis followed by TEE to detect thrombi and valvular complications. Treatment is heavily dependent on the current stage the disease is in and what their current thrombotic risk is. The case highlights the importance of a multidisciplinary approach to the post operative care plan. Anesthesiologists and the surgical team play a key role in starting patients on anti platelet therapy and resuming anti-inflammatory treatments to prevent further cardiac destruction. Monitoring patients diagnosed with HES is imperative in helping to prevent major cardiac surgery in young individuals, such as the patient in this case.