Hypereosinophilic Syndrome and Restrictive Cardiomyopathy Due to Apical Thrombi

A 57-year-old woman had a history of idiopathic hypereosinophilic syndrome (previously treated with hydroxyurea) and recent progression to myelodysplastic syndrome. She presented with 6 months of fatigue, 2 months of progressive dyspnea on exertion and orthopnea, a 10-pound weight gain, and increased abdominal girth. On admission, she appeared chronically ill and had tachycardia, jugular venous distention to the angle of the jaw, bilateral basilar rales, an S3 gallop, and trace peripheral edema. An ECG revealed …