Table 2.

Guidelines for diagnosing eosinophilic myocarditis.

1. Essential matters 1) Eosinophilia more than 500/μL 2) Cardiac symptoms such as chest pain, dyspnea and palpitation 3) Elevated levels of cardiac enzymes such as CK-MB and Troponin T 4) ECG changes 5) Transient hypertrophy or wall motion asynergy of left ventricle in ultrasonography 2. Referencing matters 1) One third of the cases have allergic disease such as bronchial asthma, rhinitis or urticaria 2) Prior to the onset of eosinophilic myocarditis, two thirds of cases have the symptoms of a common cold, such as fever, sore throat and cough.

3.Endomyocardial biopsy The infiltration of eosinophils, degranulation of eosinophils, myocytolysis and necrosis of myocytes. Interstitional edema or fibrosis are observed. In some cases, endomyocarditis is observed.

Eosinophilic myocarditis is strongly considered when the following 5 essential matters are fulfilled. Coronary angiography is recommended to exclude acute myocardial infarction. Definite diagnosis is supported by endomyocardial biopsy.