[Hypereosinophilic syndrome associated with giant negative T waves and left precordial high voltage. Echocardiographic and tomographic findings of a case].

We reported a case of hypereosinophilic syndrome with an apical thrombus obstructing left ventricular cavity near the apex and apical hypertrophy of the left ventricle demonstrated by echocardiography and computed tomography. Abnormal laboratory findings included a white blood cell count of 22,800/mm3 with 64 per cent of eosinophils, high serum IgE level, and eosinophilic abscess formation in the lymph node specimen. The electrocardiogram showed left precordial high voltage and giant negative T waves in leads V4-5. Two-dimensional echocardiograms revealed an abnormal mass obstructing the left ventricular cavity. Computed tomography demonstrated marked apical hypertrophy of the left ventricle and a filing defect of 24 X 31 mm, which attached to the interventricular septum. Because of the lack of its movement on echocardiograms and significant differences in CT numbers from various portions of the myocardium, the abnormal mass in the left ventricle was considered to be a thrombus. In this case, both echocardiography and computed tomography were very useful to understand structural relationship among the thrombus, interventricular septum and surrounding left ventricular walls, and to assess myocardial thickness of the apex. In addition, it is of particular interest that hypereosinophilic syndrome was associated with marked apical hypertrophy of the left ventricle.